End Stage Renal Diseases
Conditions
Keywords
Kidney transplantation, Organ preservation
Brief summary
Preventing ischemia/reperfusion injuries (IRIs) is a major issue in kidney transplantation, particularly for transplant recipients receiving a kidney from extended criteria donors (ECD). The main consequence of IRIs is delayed graft function (DGF). The medical device HEMO2life®, an oxygen carrier developed by the Hemarina French Company, is a natural extracellular hemoglobin (Hb) isolated from the marine lugworm Arenicola marina. This biopolymer of high molecular weight (\ 3,600 kDa) has a large oxygen binding capacity, carrying up to 156 oxygen molecules when saturated (4 for human Hb). It releases oxygen according to a simple gradient and exhibits an intrinsic superoxide dismutase-like activity preventing both the occurrence of potentially harmful heme-protein-associated free radical species and the release of Hb degradation products. Recently a safety study in 60 renal grafts using HEMO2life® as additive to organ preservation solution (Oxyop study, NCT02652520) was completed, that confirmed that the use of HEMO2life® is safe for patients and grafts. In the Oxyop study, even if the protocol was not designed to show a benefit of the use of HEMO2life®, significantly less delayed graft function (DGF) and a shorter renal function recovery was observed. The present research focuses on the efficacy of HEMO2life®, which is an oxygen carrier added in preservation solution in kidney transplantation.
Interventions
Organ preserved in preservation solution
Sponsors
Study design
Eligibility
Inclusion criteria
* For Kidney graft: * Any pair of kidneys retrieved in an adult donor in one of first line participating centers. * Any pair of kidneys from a deceased donor after brain or cardiac death * For Patient: * Male or female renal allograft recipients at least 18 years old * Patient who signed an inform consent form * Patient receiving one graft from an included pair of kidneys
Exclusion criteria
: * For kidney : * Graft from a living donor * Graft dedicated to a multi-organ transplantation or dual kidney transplantation,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of HEMO2life® as an additive to standard organ preservation solution to prevent delayed graft function following renal transplantation. | From day 0 to day 7 | Delayed graft function defined as the requirement for dialysis during the first week after transplantation will be compared as per the confirmatory testing strategy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of HEMO2life® on renal parameters compared with standard of care | From month 0 to month 12 | Evaluation using DGF assessed with alternative definitions: more than one dialysis session, need for dialysis except for hyperkaliemia or overhydration reason, time to reach a creatinine value of 250 µmol/l, DGF duration and using Renal function (creatinine value and eGFR) |
| Efficacy in specific populations depending on type of donors and the type of preservation solution. | From month 0 to month 12 | Rate of primary non function |
| Assess and compare graft and patient survival in the two groups. | From month 0 to month 12 | Graft and patient survival at one year |
| Evaluate the impact of HEMO2life® on quality of life following renal transplant at Month-1, 3 and 12. | From Day 0 to month 12 | Quality of life assess using the generic self-administered questionnaire EuroQol-5 Dimensions (EQ-5D) and a specific questionnaire for renal transplant recipients in the French language: the ReTransQol (RTQ) \[0-100\]. For RTQ, higher score mean a better outcome. |
| Safety profile of HEMO2life® post transplant | From organ preservation to month 12 | Safety profile of HEMO2life® post transplant based on 3 analysis : graft safety, recipient safety, graft function |
| Evaluate the impact of HEMO2Life® on the degree and progression of interstitial fibrosis on the pre-implantation and 3 month biopsies | biopsies pre-implantation and month 3 | Rate of biopsy-proven acute rejection at one year |
Countries
France