Rejection Clinical Trial
Official title:
Safety of Allogeneic Bone Marrow Derived Mesenchymal Stromal Cell Therapy in Renal Transplant Recipients
This study will test whether selected allogeneic bone marrow derived MSCs are safe by assessing the composite end point Biopsy Proven Acute Rejection (BPAR)/ graft loss at 12 months.
Kidney transplantation has improved survival and quality of life for patients with end-stage
renal disease. However, despite advances in immunosuppressive therapy, long-term allograft
survival outcomes have not improved over the last decade.
A promising novel therapeutic immunosuppressive option in the treatment of renal recipients
with a profound effect on the fibrosis reaction is the clinical application of mesenchymal
stromal cells (MSCs). Allogeneic MSCs offer the advantage of availability for clinical use
without the delay required for expansion.
Although it is believed that allo MSCs are immune privileged, they could possibly elicit an
anti-donor immune response, which may increase the incidence of rejection/ graft loss and
impact the allograft survival on the long term. These safety issues should be studied before
further studies are planned with allogeneic MSCs in the transplant setting.
MSCs are infused at a time point when immune suppression is lowered and the kidney is at
increased risk for developing immune mediated injury. In addition, a large amount of the
kidneys already has signs of fibrosis at this time point and MSCs might reduce the fibrosis
which so importantly affects long term survival. MSCs will have no Human Leucocyte Antigen
(HLA) sharing with the mismatches of the donor and the recipient should have no antibodies
directed to the MSCs to reduce the anti-donor immune respons risk.
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