This study is not yet accepting patients

Early Signals of the Transition From Immune Quiescence to Activation in the Liver Allograft Microenvironment and in the Circulation

a study on Liver Transplant

Summary

Eligibility
for people ages 3-13 (full criteria)
Location
at San Francisco, California and other locations
Dates
study started
study ends around
Principal Investigator
by Sandy Feng, MD, Ph.D.

Description

Summary

This is a prospective multi-center, longitudinal study to determine efficacy of 50 percent Immunosuppression (IS) reduction. One hundred fully eligible participants will reduce IS by 50 percent in two steps. Liver tests will be checked every 0.5 months through month 4, once a month through month 12, and every other month through month 18. Liver transplant (LTx) center visits will take place at screening, months 6, 12 and 18 after initiating IS dose reduction. A protocol driven liver biopsy to adjudicate the endpoint will be performed at 18 months. The duration of the study from time of starting IS dose reduction to the primary endpoint assessment is 18 months.

The primary objective is to assess the efficacy of 50 percent IS dose reduction in children with Liver transplants (LTxs)

Official Title

Early Signals of the Transition From Immune Quiescence to Activation in the Liver Allograft Microenvironment and in the Circulation (RTB-018)

Keywords

Liver Transplant, Immunosuppression, Tacrolimus reduction

Eligibility

You can join if…

Open to people ages 3-13

  1. Participant and parent or guardian must be able to understand and provide informed assent and consent, respectively
  2. Recipient of a living or deceased donor Liver transplant (LTx) at <7 years of age
  3. > 3 years but <7 years after LTx at the time of study enrollment
  4. Stable liver tests defined as baseline serum alanine aminotransferase (ALT) level < 30 IU/l and gamma-glutamyl transferase (GGT) level < 50 IU/l (based on the average of the 3 most recent values prior to screening; all must be within 1 year of screening; 2 must be within 6 months of screening)
  5. No Acute rejection (AR) or chronic rejection within 12 months of enrollment
  6. Tacrolimus monotherapy for > 6 months with baseline 12-hour trough levels <8 ng/mL (based on the average of 3 values prior to screening; all must be within 1 year of screening; 2 must be within 6 months of screening)
  7. Participants of childbearing potential must have a negative pregnancy test upon study entry

You CAN'T join if...

  1. Liver transplant (LTx) for autoimmune disease, including autoimmune hepatitis or primary sclerosing cholangitis
  2. LTx for hepatitis B or hepatitis C
  3. Recipient of any other organ transplant or liver re-transplant, except for patients who have a repeat LTx within 30 days of first LTx who are eligible for enrollment
  4. >=50 percent dose increase in tacrolimus within 12 months of enrollment
  5. Discontinued a second Immunosuppression (IS) agent within 12 months of enrollment
  6. Systemic illness requiring chronic or recurrent use of IS for which there is a risk of reactivation if tacrolimus is reduced
  7. Use of medication to treat systemic conditions which in the judgement of the investigator could influence results of the study
  8. Active or chronic infection requiring treatment
  9. Inability or unwillingness to comply with the study protocol
  10. Use of investigational drug within 4 weeks (or 5 half-lives of investigational drug, whichever is longer) of enrollment
  11. Has any condition that, in the opinion of the investigator, will interfere with safe participation in the trial

Locations

  • UCSF Benioff Children's Hospital
    San Francisco California 94143 United States
  • Children's Hospital Colorado
    Aurora Colorado 80045 United States

Lead Scientist at UCSF

  • Sandy Feng, MD, Ph.D.
    Dr. Sandy Feng is a transplant surgeon who performs liver, kidney and pancreas transplants. In her research, Feng studies transplantation tolerance, a transplant recipient's ability to maintain normal organ function with minimal or no use of immunosuppressive drugs.

Details

Status
not yet accepting patients
Start Date
Completion Date
(estimated)
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
ID
NCT07549503
Phase
Phase 2 Liver Transplant Research Study
Study Type
Interventional
Participants
Expecting 100 study participants
Last Updated