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Tolerance by Engaging Antigen During Cellular Homeostasis
Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)
Summary
Anti-rejection medicines, also known as immunosuppressive drugs, are prescribed to organ transplant recipients to prevent rejection of the new organ. Long-term use of these medicines places transplant recipients at higher risk of serious infections and certain types of cancer. The purpose of this study was to determine if: * it was safe to give mesenchymal stromal cells (MSCs) to kidney transplant recipients, and * the combination of the immunosuppressive (anti-rejection) study drugs plus the MSCs could allow a kidney transplant recipient to slowly reduce and/or then completely stop all anti-rejection drugs, without rejection of their kidney (renal) allograft, a process called "immunosuppression withdrawal".
Official title: Donor-derived Mesenchymal Stromal Cells, Alemtuzumab, Co-stimulation Blockade and Sirolimus for Tolerance Induction in Adult Kidney Allograft Recipients (ITN062ST)
Key Details
Gender
All
Age Range
19 Years - Any
Study Type
INTERVENTIONAL
Enrollment
16
Start Date
2018-07-30
Completion Date
2025-09-16
Last Updated
2026-10-29
Healthy Volunteers
No
Interventions
Donor-derived Mesenchymal Stromal Cells
These MSCs were a cellular product derived from bone marrow and propagated ex vivo using FDA-approved, clinically applicable methods. Their use in kidney transplantation has been associated with a good safety profile.
alemtuzumab
Alemtuzumab, 30 mg, was given once intravenously (IV) over three hours. The infusion of alemtuzumab began within 24 hours of transplantation surgery and was given prior to the first dose of belatacept.
belatacept
Belatacept was given as an intravenous (IV) infusion of 10mg /kg over 1 hour on transplantation postoperative Day 0, Days 5 and 14, then every 2 weeks (± 2 days) for 5 additional doses. Thereafter, belatacept was given once every 4 weeks (± 5 days) at 10 mg/kg through 24 weeks post-transplant, then at 5 mg/kg every 4-weeks until the participant was evaluated for belatacept discontinuation.
sirolimus
Rapamune® (sirolimus) (Wyeth Pharmaceuticals Inc., Philadelphia, PA) was started on transplantation postoperative day 1 at a dose of 2 mg/day orally and adjusted to maintain goal 24-hour trough levels of 8-10 ng/ml. Participants who experienced grade 3 sirolimus toxicity underwent dose reduction.
mycophenolate mofetil
Per protocol and was only permitted in cases of sirolimus intolerance.
mycophenolate acid
Per protocol and was only permitted in cases of sirolimus intolerance.
prednisone
Per protocol and was only permitted in cases of sirolimus intolerance.
Locations (1)
Duke University Health System
Durham, North Carolina, United States