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Infusion of T-Regulatory Cells in Kidney Transplant Recipients (The ONE Study)

Renal Transplantation Followed By Infusion of T-Regulatory Cells Made With Belatacept Ex-Vivo

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02091232
Enrollment
4
Registered
2014-03-19
Start date
2014-05-31
Completion date
2016-03-02
Last updated
2024-03-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Kidney Failure, Kidney Transplant

Brief summary

This research study is for patients who are going to receive a kidney transplant from a living donor. After kidney transplantation, it is necessary for transplant recipients to take immunosuppressive drugs. These drugs work by preventing the body's immune cells from attacking and rejecting the new kidney. Taking these drugs long-term may also cause harm to the transplanted kidney. Therefore, the transplant community is very interested in finding ways to decrease immunosuppressive drug treatment and further reduce the risk of kidney rejection. One method to do so is known as induction of tolerance, which is when the person who receives a transplant has treatment to make their immune cells tolerant to the donor cells. In this study, we will try to induce tolerance by mixing recipient cells and their donor's cells together with belatacept, an immunosuppressive drug. Belatacept is a protein that attaches to immune system cells, interferes with the immune response and results in tolerance induction. After we mix the recipient cells with the donor's cells, we will sort out one particular kind of immune cell, called a regulatory T cell, and inject them back into the recipient. Regulatory T cells are the cells that are affected by induction to reduce rejection of donated organs. This method for inducing tolerance has been used in bone marrow transplantation, but this is the first time it is being done in kidney transplantation. This study is being conducted as part of a unique collaboration of US and EU centers called The ONE Study. The ONE Study centers have agreed to work together using common protocols and procedures but with each testing their own regulatory population for safety and the ability to promote kidney survival. Sharing data among the participating sites will permit a deeper understanding of how and why some treatments might succeed while others work less well.

Interventions

BIOLOGICALT Regulatory Cell Infusion

After blood is collected from the donor and recipient, the facility will sort out one particular kind of immune cell called a regulatory T cell which is strongly influenced by tolerance induction to minimize (suppress) responses to the donor cells. In this study, these regulatory T cells are the cells which will be given back to the recipient on Day 7 (+3 days) post-transplant.

Sponsors

Dana-Farber Cancer Institute
CollaboratorOTHER
University of Regensburg
CollaboratorOTHER
Massachusetts General Hospital
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Key Recipient Inclusion Criteria: * Chronic renal insufficiency necessitating kidney transplantation * Aged at least 18 years * Donor is ABO (Blood type) compatible Key Recipient

Exclusion criteria

* HIV positive, EBV negative, or suffering from chronic viral hepatitis or tuberculosis * Previously received any tissue or organ transplant other than planned kidney graft * Genetically identical to the prospective organ donor at the HLA loci (0-0-0 mismatch) * Panel Reactive Antibodies (PRA) \>20% * Concomitant malignancy or history of malignancy within 5 years prior to planned study entry (excluding successfully-treated non metastatic basal/squamous cell carcinoma of the skin) * Ongoing treatment with systemic immunosuppressive drugs at study entry

Design outcomes

Primary

MeasureTime frameDescription
Safety and Feasibility of T Regulatory Cell Infusion in Renal Transplantation2 WeeksTo examine in living donor renal transplant recipients the safety and feasibility of administering T regulatory cells derived from recipient PBMC stimulated with kidney donor PBMC in the presence of costimulatory blockade with belatacept.

Secondary

MeasureTime frameDescription
T-Reg Measurements2 YearsTo measure the presence, potency, and specificity of Treg in the peripheral circulation of kidney transplant recipients. This will be done by in-vitro testing of the T-reg cell product and peripheral blood.
Reduction of Immunosuppression60 WeeksTo develop preliminary information on whether administration of the Treg cell product allows a tapering of conventional maintenance immunosuppression within 60 weeks after transplantation.

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 27, 2026