A prospective, open-label, uncontrolled, non-randomized, single-center Phase I/II clinical trial evaluating the safety of Anakinra in the immediate post-transplant period following pancreatic transplantation
Pancreas transplantation is the treatment of choice for curing diabetes by restoring long-term endogenous insulin secretion. However, the increased risk of rejection compared to other transplants, and especially the risk of early graft loss due to immunological thrombosis, are major obstacles to this procedure. IL-1β blockade is commonly used in islet transplantation, as it has demonstrated a benefit in terms of graft survival when administered immediately postoperatively, in combination with TNFα blockade18. The ILIPO study therefore aims to evaluate the safety of anti-IL-1β treatment as an adjunct to the regimen currently used in our department for pancreatic transplants.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Safety of Anakinra in the immediate aftermath of pancreatic transplantation
CHU Nantes
Nantes, France
evaluate the safety of IL-1β in a pilot study of patients who have undergone a pancreas transplant
Type, severity (CTACAE, and 2012 KDIGO classification for kidney damage) and number (and percentage) of adverse events occurring within the first year following pancreatic transplantation, with a particular focus on severe infections (bacterial, viral, fungal, or parasitic infections that are life-threatening and/or require hospitalization), the occurrence of rejection confirmed by biopsy, and graft survival compared to a historical control cohort (DIVAT Nantes Cohort).
Time frame: 1 year
Assess patient survival one year after transplantation
Patient survival will be determined by the patients who are still alive one year after pancreatic transplantation.
Time frame: 1 year
Assess pancreatic graft survival one year post-transplant
Pancreatic transplant failure is defined as the occurrence of any of the following criteria within one year of transplantation: The need for daily insulin treatment and/or removal of the pancreatic graft (i.e., pancreatic graft transplantectomy) and/or pancreatic retransplantation and/or islet of Langhans transplantation.
Time frame: 1 year
Assess pancreatic graft function
Assessment of C-peptide (ng/mL) one year after transplantation to calculate the β2 score and IGLS criteria.
Time frame: 1 year
Assess pancreatic graft function
Assessment of fasting blood glucose (mmol/l) one year after transplantation to calculate the β2 score and IGLS criteria.
Time frame: 1 year post-transplant
Assess pancreatic graft function
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Assessment of insulin requirements (number of units) one year after transplantation to calculate the β2 score and IGLS criteria.
Time frame: 1 year
Assess pancreatic graft function
Assessment of HbA1c (percent) one year after transplantation to calculate the β2 score and IGLS criteria.
Time frame: 1 year
Assess pancreatic graft function
Assessment of an oral glucose tolerance test (normal/anormal) one year after transplantation.
Time frame: 1 year
Assess renal graft function (in the case of simultaneous kidney-pancreas transplantation)
Assessment of serum creatinine levels (mmol/24h) one year after simultaneous kidney-pancreas transplantation.
Time frame: 1 year
Assess renal graft function (in the case of simultaneous kidney-pancreas transplantation)
Assessment of estimated glomerular filtration rate (ml/min/1.73m²) (using the CKD-EPI formula) one year after simultaneous kidney-pancreas transplantation.
Time frame: 1 year
Assess renal graft function (in the case of simultaneous kidney-pancreas transplantation)
Assessment of proteinuria (mg/24h) one year after simultaneous kidney-pancreas transplantation.
Time frame: 1 year
Assess the occurrence of severe bacterial infections
The occurrence of severe bacterial infections, i.e. those requiring hospitalisation.
Time frame: up to 1 year
Assess the occurrence of Cytomégalovirus infection
Occurrence of CMV viremia, whether asymptomatic and/or associated with CMV disease (i.e. organ involvement linked to CMV replication: haematological, gastrointestinal, hepatic or pulmonary).
Time frame: up to 1 year
Assess the occurrence of BK virus infection
Occurrence of BK virus viremia, whether asymptomatic and/or associated with BK virus nephropathy confirmed by biopsy.
Time frame: up to 1 year
Assess the occurrence of fungal infection
Time frame: up to 1 year
Assess the occurrence of pancreatic graft rejection
Occurrence of pancreatic rejection confirmed by pancreatic biopsy (according to the Banff criteria) and/or by renal biopsy in the presence of findings consistent with associated pancreatic rejection
Time frame: up to 1 year
Assess the occurrence of renal graft rejection (in the case of simultaneous kidney-pancreas transplantation)
Time frame: up to 1 year
Assess the occurrence of graft-specific antibodies
Development of anti-graft antibodies at one year, considered significant where the Mean Fluorescence Index is \> 500.
Time frame: 1 year