NCT06171438

Brief Summary

Scoring systems that combine donor clinical and morphological parameters to predict outcome of kidney transplantation lack enough specificity to be generally accepted. Compare to classical histology, molecular assessment of renal tissue offers unbiased and technically robust approach. In this prospective 3-months' observational study procurement biopsies in 180 brain death donors will be performed. Using microarray which detect top differently regulated genes, conventional histology, urinary AKI biomarkers, renal function and clinical variables models predicting DGF and early graft scarring (IFTA, poor graft function) in recipients will be constructed. The associations of AKI in donors with distinct fibrosis atrophy and AKI molecular signals will be found. Molecular techniques and final models may help to improve the decision-making process for the acceptance of kidneys from marginal donors but more importantly, it may help clinicians to guide less toxic immunosuppression in identified problematic grafts.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
200

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Jun 2021

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 11, 2021

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2022

Completed
11 months until next milestone

Study Completion

Last participant's last visit for all outcomes

October 31, 2023

Completed
28 days until next milestone

First Submitted

Initial submission to the registry

November 28, 2023

Completed
16 days until next milestone

First Posted

Study publicly available on registry

December 14, 2023

Completed
Last Updated

December 14, 2023

Status Verified

December 1, 2023

Enrollment Period

1.5 years

First QC Date

November 28, 2023

Last Update Submit

December 12, 2023

Conditions

Keywords

kidney transplantationdonor kidneymicroarray

Outcome Measures

Primary Outcomes (1)

  • Kidney graft function at month 3

    Kidney graft function is measured as estimated glomerular filtration in ml/s/1.73m2.

    3 months

Secondary Outcomes (11)

  • Kidney graft survival

    1 year

  • Delayed graft function

    1 week

  • Fibrosis grade at month 3

    3 months

  • Gene expression in Donor kidney

    3 months

  • Gene expression in 3-month protocol biopsy of recipient

    3 months

  • +6 more secondary outcomes

Study Arms (6)

Acute kidney injury (AKI)

Donors with AKI (acute kidney injury) defined based on the results of creatinine increase and diuresis decrease before organ harvest.

Diagnostic Test: Urine BiomarkersDiagnostic Test: Gene expression profiling of donor kidneys by microarrayDiagnostic Test: Gene expression profiling of recipient kidneys by microarray

no-AKI

Donors without AKI (acute kidney injury) defined based on the results of creatinine increase and diuresis decrease before organ harvest.

Diagnostic Test: Urine BiomarkersDiagnostic Test: Gene expression profiling of donor kidneys by microarrayDiagnostic Test: Gene expression profiling of recipient kidneys by microarray

delayed graft function (DGF)

Donors and the paired recipients in whom the organ was transplanted in IKEM (Institute for Clinical and Experimental Medicine) who developed delayed graft function (DGF) defined as dialysis in the 1st week after transplantation.

Diagnostic Test: Urine BiomarkersDiagnostic Test: Gene expression profiling of donor kidneys by microarrayDiagnostic Test: Gene expression profiling of recipient kidneys by microarray

no-DGF

Donors and the paired recipients in whom the organ was transplanted in IKEM (Institute for Clinical and Experimental Medicine) with immediate graft function (no-DGF).

Diagnostic Test: Urine BiomarkersDiagnostic Test: Gene expression profiling of donor kidneys by microarrayDiagnostic Test: Gene expression profiling of recipient kidneys by microarray

Recipient IFTA

Donors and the paired recipients in whom the organ was transplanted in IKEM with 3-month protocol biopsy histology finding of IFTA≥2.

Diagnostic Test: Gene expression profiling of donor kidneys by microarrayDiagnostic Test: Gene expression profiling of recipient kidneys by microarray

Recipient no-IFTA

Donors and the paired recipients in whom the was transplanted in IKEM with 3-month protocol biopsy histology finding of IFTA\<2.

Diagnostic Test: Gene expression profiling of donor kidneys by microarrayDiagnostic Test: Gene expression profiling of recipient kidneys by microarray

Interventions

Urine BiomarkersDIAGNOSTIC_TEST

Biomarkers of kidney damage in donors, such as neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-D-glucosaminidase (NAG), beta2-microglobulin, alpha1-microglobulin, alpha2-macroglobulin and transferrin will be measured by ELISA.

Acute kidney injury (AKI)delayed graft function (DGF)no-AKIno-DGF

Gene expression profiling of donor kidney biopsies using Affymetrix microarray platform (PrimeView Human Gene Expression Array).

Acute kidney injury (AKI)Recipient IFTARecipient no-IFTAdelayed graft function (DGF)no-AKIno-DGF

Gene expression profiling of donor kidney biopsies using Affymetrix microarray platform (PrimeView Human Gene Expression Array).

Acute kidney injury (AKI)Recipient IFTARecipient no-IFTAdelayed graft function (DGF)no-AKIno-DGF

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

All DBD donors whose kidneys will be procured by IKEM transplant team either in donor hospital or at IKEM. Corresponding recipients, transplanted at IKEM will be further monitored. Patients will receive standard immunosuppression based on tacrolimus, mycophenolate mofetil and steroids along with induction (basiliximab in low risk and rATG in high-risk) according to center protocol. All procedures in transplant recipients will be routine ones, included for cause biopsies and 3M protocol biopsy (standard of care in the center).

You may qualify if:

  • All DBD (donation after brain death) donors whose kidneys will be procured by transplant team of Institute for Clinical and Experimental Medicine (IKEM) in donor hospital.
  • All DBD (donation after brain death) donors whose kidneys will be procured by transplant team of Institute for Clinical and Experimental Medicine (IKEM) at IKEM.

You may not qualify if:

  • Donors with circulatory death
  • Donors with machine perfusion
  • Donors with multiorgan transplantation.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Institute for Clinical and Experimental Medicine

Prague, 140 21, Czechia

Location

Biospecimen

Retention: SAMPLES WITH DNA

donor and recipient kidney biopsies, urine and blood samples of donor

MeSH Terms

Conditions

Acute Kidney Injury

Condition Hierarchy (Ancestors)

Renal InsufficiencyKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital Diseases

Study Officials

  • Ondrej Viklicky, Prof.

    Institute for Clinical and Experimental Medicine

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER GOV
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Head of Department of Nephrology and Transplant Center

Study Record Dates

First Submitted

November 28, 2023

First Posted

December 14, 2023

Study Start

June 11, 2021

Primary Completion

December 1, 2022

Study Completion

October 31, 2023

Last Updated

December 14, 2023

Record last verified: 2023-12

Locations