Title

Panel Reactive Antibody (PRA) Reduction in Sensitized Patients Awaiting Renal Transplantation
Reduction of PRA (Panel Reactive Antibody) in Sensitized Patients Awaiting Live-Donor Renal Transplantation
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Study Participants

    26
The purpose of this study is to offer Panel Reactive Antibodies [PRA] reduction treatment to high responder renal transplant patients who otherwise may never be compatible with a potential organ donor. PRA reduction is offered in the following phases:

Immunological Testing
Transplant Nephrectomy
Pharmacologic Therapy
Plasmapheresis
Transplant
Patients with high level of preformed antibodies (panel reactive antibodies [PRA]) to donor antigens make identification of a suitable donor difficult. For most transplant centers, 20-35% of patients waiting for a kidney transplant comprise this challenging group. These patients have a wait time of over five years and have many incompatible cross-matches with potential organ donors.
Study Started
Jan 31
2002
Primary Completion
Dec 31
2010
Study Completion
Apr 30
2012
Results Posted
Jun 29
2015
Estimate
Last Update
Jun 29
2015
Estimate

Drug CMVIG

400mg/kg IV (60mg/kg/IV/hr initially, titrated up) once a week up to four weeks

  • Other names: Cytomegalovirus Immune Globulin - Intravenous, Cytogam

CMVIG followed by PP No Intervention

MMF or rapamycin was given with CMVIG for 4 weeks followed by plasmapheresis

Criteria

Inclusion Criteria:

Renal transplant recipients with a potential living donor who is incompatible (T-&/or B-cell locus) due to recipient high PRA or MHC antibodies
PRA greater than or equal to 20% within last twelve months
Recipient and donor accepted as potential candidates by the LifeLink Healthcare Renal Transplant Committee

Exclusion Criteria:

Patients with known allergy to CytoGam(R), Cellcept, Rapamycin
Patients who will receive IVIG or CytoGam(R) for any cause prior to protocol process
ABO incompatibility
Patients not capable of following through the treatment for various reasons as determined by treating physicians
Any potential recipient who is pregnant or becomes pregnant
Exclusion for Plasmapheresis: known allergy to ethylene oxide or natural rubber latex.
Exclusion for Plasmapheresis: Intake of ACE-inhibitor or Angtiotensiin-receptor blockers in the last 24 hours prior to plasma exchange

Summary

Highly Sensitized Patients

All Events

Event Type Organ System Event Term

The Percent of Sensitized Patients Treated With PRA Reduction Pharmacological Therapy, Including Cytogam, Who Become Cross-match Compatible With Potential Living Donor

The percent of sensitized patients treated with PRA Reduction Pharmacological Therapy, including Cytogam, who become cross-match compatible with potential living donor. Treatment success defined as achieving a decrease in donor specific antibody and eliminating cross-match incompatibility sufficient to allow transplantation.

Highly Sensitized Patients

40.0
percent of subjects becoming compatible

Monitor Graft Survival

Outcome Measure Data Not Reported

Monitor Patient Survival

Outcome Measure Data Not Reported

Age, Continuous

42
years (Mean)
Standard Deviation: 10.6

Percent of subjects with PRA >/= 20% in last 12 months

76
percent of subjects with elevated PRA

Sex: Female, Male

Overall Study

CMVIG Followed by PP

Drop/Withdrawal Reasons

CMVIG Followed by PP