Kidney Failure, Chronic Clinical Trial
Official title:
Evaluation of Immune Globulin Intravenous (Human), 10%, Manufactured by Chromatography Process (IGIV-C, 10%), as an Agent to Reduce Anti-HLA Antibodies and Improve Transplantation Results in Cross Match Positive Living Donor Kidney Allograft Recipients
The purpose of this study is to determine if IGIV-C, 10% will be effective in converting a donor-recipient crossmatch status from positive to negative. The crossmatch test is used to determine if the donor tissue and recipient tissue are compatible. The study will also evaluate if IGIV-C, 10% will allow successful kidney transplantation in a patient who otherwise would not be able to receive a transplant. Three dose levels of IGIV-C, 10% will be evaluated to determine what dose level is most effective.
Kidney transplantation has emerged as the treatment of choice for patients with end-stage
renal disease (ESRD). Preliminary data suggest that IGIV therapy could have significant
benefits in modifying allograft rejection episodes, stabilizing long-term allograft
function, and reducing ischemia/reperfusion injury.
Qualified patients will have an in-vitro assessment of the ability of IGIV-C, 10% to convert
the donor-specific crossmatch (cytotoxic assay) from positive to negative. Those patients
with successful in-vitro conversion of the donor-specific crossmatch assay will be
randomized to receive IGIV-C, 10% intravenously at a dose of either 2 gm/kg, 1 gm/kg, or 0.5
gm/kg. IGIV-C, 10% will be administered 3 to 5 days prior to planned transplantation and, if
transplantation is successful, 7 days post-transplant. If after receiving the IGIV-C
infusion the donor-specific crossmatch reveals that cell death has fallen to 20% or less
above background, the crossmatch will be considered negative. If after receiving one
infusion the crossmatch remains positive, additional IGIV-C infusions may be administered at
one-month intervals, up to 4 infusions. A repeat crossmatch must be obtained after each
infusion. Patients will be followed for 12 months post-transplant. Concomitant therapy will
include a standard immunosuppression regimen of mycophenolate mofetil, tacrolimus, and
prednisone following induction therapy with thymoglobulin.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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