Kidney Transplant Rejection
Conditions
Keywords
kidney transplant, cellular therapy, anti-rejection therapy, living donor, HLA-matched, hematopoietic stem cells (HSC), CD34+, CD3+, T cells
Brief summary
The primary objective of this study is to demonstrate the safety and efficacy of cellular immunotherapy with MDR-101 for induction of functional immune tolerance in recipients of human leukocyte antigen (HLA)-matched, living donor kidney transplants.
Detailed description
Currently, patients receiving a transplanted kidney are required to take life-long immunosuppressive medications to prevent rejection of the transplanted kidney. These medications carry substantial side effects. In addition, these medicines often do not completely control damage to the kidney from the recipients' immune system, ultimately causing the kidney to fail. Medeor Therapeutics is developing a novel cell-based therapy to reprogram the recipients' immune system to accept a transplanted kidney without the need for long term use of immunosuppression drugs. The purpose of the current Phase 3 study is to demonstrate the efficacy and safety of MDR-101 for the induction of transplant immune tolerance in a prospective, randomized, multicenter clinical trial. MDR-101 is intended to induce mixed lymphohematopoietic chimerism and donor specific immune tolerance in order to preserve transplant kidney function, avert transplant kidney rejection, and eliminate the cumulative and serious side effects associated with immunosuppressive drugs.
Interventions
BIOLOGICALMDR-101
Enriched CD34+ hematopoietic stem cells and defined dose of CD3+ T-cells
Sponsors
California Institute for Regenerative Medicine (CIRM)
Medeor Therapeutics, Inc.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Total lymphoid irradiation and anti-thymocyte globulin
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Recipient Inclusion Criteria: * Planned recipient of a first kidney allograft from an HLA-matched, living related donor * Age ≥18 and ≤70 years * Single solid organ recipient (kidney only) * ABO matched with donor Recipient
Exclusion criteria
* Underlying kidney disease with a high risk of disease recurrence in the transplanted kidney * Baseline positive donor-specific anti-HLA antibody testing * Is taking immunosuppressive therapy * Evidence of prior hepatitis B (HBV) or hepatitis C (HCV) Donor Inclusion Criteria: * HLA-matched first degree (parent, child or sibling) or second-degree (child of a sibling or half sibling) relative of the prospective recipient participant * Age ≥18 and ≤70 years * Prepared to be a living related kidney donor, and capable of undergoing G-CSF mobilization and apheresis of hematopoietic cells Donor
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional immune tolerance defined as | Up to 36 months post-kidney transplant | * Achievement of the required duration of persistent donor mixed chimerism to permit calcineurin inhibitor immunosuppressive withdrawal beginning at 6-7 months post-kidney transplant surgery, and * Successful withdrawal from all immunosuppressives by at least 12 months post-kidney transplant surgery, and * Subsequent successful maintenance off all immunosuppressive drugs for at least 24 additional months (out to at least 36 months post-kidney transplant surgery) without biopsy-proven acute rejection, de novo Donor Specific Antibody, transplant kidney loss, or subject death. Loss to follow-up will be adjudicated as a failure in intent-to-treat analysis. |
Countries
Canada, United States
Outcome results
None listed