This investigator-initiated study will analyse the role of pre-formed alloreactive T cells on acute rejection episodes and graft outcome in kidney transplant recipients after living donation.
In recipients of solid organ transplants, preformed alloreactive T cells may mediate acute rejections and compromise long-term graft survival. Previous studies on the role of alloreactive T cells in transplantation were hampered by the fact that experimental assays to quantify alloreactivity were technically demanding and not suitable for use in a clinical setting. Based on a recent development of a whole-blood assay, alloreactive T cells may be quantified and characterised within one day. This assay therefore provides the experimental basis to study the development and the role of alloreactive T cells in a clinical setting in patients after renal transplantation. This will be performed in a multicenter study in living donor renal transplant recipients where preformed alloreactivity of the recipient towards the living donor will be determined and associated with standard clinical parameters of graft function and long-term graft outcome on follow-up. In addition, the development of donor-specific antibodies will be analysed after transplantation. If this project was able to provide evidence for a role of alloreactive T cells in acute rejection episodes or long-term graft function, this assay may in future be used to guide individualized immunosuppressive drug treatment early after transplantation. It will thereby aid in distinguishing patients where standard immunosuppressive drug regimens are sufficient from the minor population of patients at high risk for rejection who will benefit from intensified drug regimens.
Study Type
OBSERVATIONAL
Enrollment
190
Saarland University
Homburg, Saarland, Germany
Medizinische Klinik II, Aachen University
Aachen, Germany
Charité Berlin
Berlin, Germany
graft function
1-year graft function (estimated glomerular filtration rate)
Time frame: 1 year
Creatinine
1-year creatinine
Time frame: 1 year
Cystatin C
1-year cystatin C
Time frame: 1 year
rejection: acute rejection episodes within the first year
Time frame: 1 year
proteinuria within the first year
Time frame: 1 year
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Klinikum Köln-Lindenthal
Cologne, Germany
University Erlangen Nürnberg
Erlangen, Germany
Medizinische Klinik III, Frankfurt University
Frankfurt, Germany
University Clinic of Giessen and Marburg (UKGM)
Giessen, Germany
Universitätsklinikum Hamburg Eppendorf
Hamburg, Germany
Transplantationszentrum Heidelberg - Nephrologie
Heidelberg, Germany
University of Lübeck
Lübeck, Germany
...and 3 more locations