The study is designed to evaluate the safety and efficacy of an intravenously administered drug in recipients of kidneys from cardiac death donors who are risk for developing delayed graft function.
Renal transplantation is the most effective and cost-efficient form of renal replacement therapy for a burgeoning population that presents with end-stage renal disease. Although organ donation has become a national priority, the gap between the number of patients awaiting a kidney versus the number of available kidneys continues to widen exponentially. In many countries within the European Union, utilization of "donation after cardiac death" (DCD) kidneys is steadily increasing, expanding the donor pool by \> 50%. Given the high incidence of cardiac deaths in the US, aggressive pursuit of the DCD kidney pool could potentially reduce waitlist periods to months, if not days. Risk for delayed graft function (DGF) with the attendant risks for increased recipient morbidity, chronic allograft nephropathy and increased medical costs has however tempered DCD kidney utilization in this country. Development of strategies that limit normothermic reperfusion injury, promote renal repair, reduce the incidence and/or duration of DGF and improve long-term outcome can greatly enhance acceptance and recruitment of DCD kidneys. The study is designed to evaluate the safety and efficacy of an intravenously administered drug in recipients of kidneys from DCD donors who are risk for developing DGF. This trial is unique in that it compares drug versus placebo outcome in kidney recipients from the same donor with direct evaluation of function (creatinine clearance) in the graft.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
12
Daily intravenous administration of 2mg/kg for 4 days
Daily intravenous administration for four (4) days. The volume of normal saline will vary by estimated weight.
Maastricht University Medical Center
Minderbroedersberg, Maastricht, Netherlands
Hospital Clínico San Carlos
San Carlos, Madrid, Spain
The Newcastle Upon Tyne Hospital
Newcastle, Metropolitan County of Tyne and Wear, United Kingdom
creatinine clearance
The primary analysis to assess the activity of BB3 compared to placebo will be the mean difference in creatinine clearance over time using selective 24-hour urine collections from the transplanted kidney from the first infusion of study drug through day 7 post-transplant.
Time frame: 7 days
Urine production
Median time (days) until production of ≥1 litre urine over a 24-hour period, i.e. median number of days following the first infusion of study drug until the first day (08:00 - 08:00) that urine production was ≥1 litre over a 24-hour period.
Time frame: 28 days
Creatinine clearance
Calculated creatinine clearance at days 14 and 28
Time frame: 28 days
Incidence of delayed graft function
Incidence of delayed graft function (required dialysis due to inadequate renal function during the first 7 days after transplantation).
Time frame: 7 days
Number of dialysis sessions
Number of dialysis sessions through day 7, 14, and 28
Time frame: 28 days
Mean total daily urine output
Mean total daily urine output through day 14
Time frame: 14 days
Daily serum creatinine
Daily serum creatinine at days 1 to 7
Time frame: 7 days
Mean serum creatinine
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Mean serum creatinine at days 4, 7, 10, 14, and 28
Time frame: 28 days
Length of hospitalization following transplantation
Length of hospitalization following transplantation
Time frame: 28 days
Follow-up on graft survival and function
Results of the 6- and 12-month follow-up on graft survival and function will be summarized as an addendum to the final clinical study report
Time frame: 12 months