To collect evidence of the safety of administering donor-derived regulatory macrophage (M reg) preparations to living-donor renal transplant recipients in the context of an international European Union funded consortium aimed at evaluating cellular immunotherapy in solid organ transplantation (The ONE Study). It is anticipated that immune regulation induced by M reg therapy can eventually be used to reduce the need for conventional immunosuppression in transplant recipients.
Decades of immunosuppressive drug development has produced an array of powerful pharmacological agents, but the various drawbacks associated with these treatments leaves considerable room for improvement. By harnessing the power of suppressive mechanisms in the human immune system, regulatory cell therapy may be able to support peripheral tolerance and induce a level of donor-specific unresponsiveness that allows for a reduction in the use of conventional immunosuppression in organ transplant recipients. Several alternative regulatory cell types have been identified as potential adjunct immunotherapies for solid organ transplantation and are now approaching a stage of development that would allow clinical testing in an early-stage trial. The EU-funded international ONE Study consortium aims to answer the question as to whether M reg treatment, or other immunoregulatory cell-based therapies, can be advanced in the clinical management of solid organ transplant recipients. This particular M reg trial aims to explore the potential of M reg therapy as an adjunct immunosuppressive treatment in living-donor renal transplant recipients through a clinical protocol design shared by other investigators in The ONE Study group testing additional regulatory cell therapies in separate trials.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
8
Experimental: M reg treatment Donor M reg (2.5-7.5 million cells/kg) IV infused (6-7d before Tx) into recipients of a living donor renal Tx. Recipients also receive prednisolone, mycophenolate mofetil and tacrolimus background immunosuppression (as described in detail in the arm description).
University Hospital Regensburg
Regensburg, Germany
biopsy-confirmed acute rejection incidence
Time frame: 60 weeks
time to first acute rejection episode
Time frame: 60 weeks
severity of acute rejection episodes
based on response to treatment and histological scoring
Time frame: 60 weeks
total immunosuppressive burden
assessed at last study visit
Time frame: 60 weeks
incidence of patients treated for subclinical acute rejection
Time frame: 60 weeks
prevention of chronic graft dysfunction (chronic rejection or IF/TA)
assessed by clinical (impairment of GFR) and histopathological (Banff staging) measures
Time frame: 60 weeks
incidence of post-transplant dialysis, inclusion on the transplant waiting list or re-transplantation following graft loss through rejection
Time frame: 60 weeks
avoidance of drug-related complications by immunosuppressant reduction
assessed by the incidence of reported adverse drug reactions
Time frame: 60 weeks
incidence of embolic pulmonary complications and other embolic events
Time frame: 60 weeks
incidence of immunological reactions resulting in anaphylactoid reactions, immediate cardiovascular compromise or other acute organ failure
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: 1 week
biochemical disturbances caused by cell infusion
Time frame: 1 week
over-suppression of the immune system assessed by the incidence of major and/or opportunistic infections, especially CMV, EBV and polyoma virus
Time frame: 60 weeks
over-suppression of the immune system assessed by the incidence of neoplasia
Time frame: 60 weeks
immunological condition of study patients
an extensive immune monitoring program has been established in The ONE Study
Time frame: 60 weeks