Trial Outcomes & Findings for Low Dose Thymoglobulin to Protect Kidney Function After Liver Transplant (NCT NCT00970073)

NCT ID: NCT00970073

Last Updated: 2018-10-09

Results Overview

Postoperative acute kidney injury is measured as reduced (eGFR) within 12 months post-surgery.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

30 participants

Primary outcome timeframe

12 Months

Results posted on

2018-10-09

Participant Flow

Participant milestones

Participant milestones
Measure
Delayed CNI Group 1
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Overall Study
STARTED
10
10
10
Overall Study
COMPLETED
10
10
10
Overall Study
NOT COMPLETED
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Delayed CNI Group 1
n=10 Participants
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
n=10 Participants
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
n=10 Participants
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Total
n=30 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=10 Participants
0 Participants
n=10 Participants
0 Participants
n=10 Participants
0 Participants
n=30 Participants
Age, Categorical
Between 18 and 65 years
9 Participants
n=10 Participants
9 Participants
n=10 Participants
10 Participants
n=10 Participants
28 Participants
n=30 Participants
Age, Categorical
>=65 years
1 Participants
n=10 Participants
1 Participants
n=10 Participants
0 Participants
n=10 Participants
2 Participants
n=30 Participants
Sex: Female, Male
Female
2 Participants
n=10 Participants
1 Participants
n=10 Participants
3 Participants
n=10 Participants
6 Participants
n=30 Participants
Sex: Female, Male
Male
8 Participants
n=10 Participants
9 Participants
n=10 Participants
7 Participants
n=10 Participants
24 Participants
n=30 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
10 Participants
n=10 Participants
10 Participants
n=10 Participants
10 Participants
n=10 Participants
30 Participants
n=30 Participants

PRIMARY outcome

Timeframe: 12 Months

Postoperative acute kidney injury is measured as reduced (eGFR) within 12 months post-surgery.

Outcome measures

Outcome measures
Measure
Delayed CNI Group 1
n=10 Participants
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
n=10 Participants
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
n=10 Participants
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Estimated Glomerular Filtration Rate (eGFR) at 12 Months Post-surgery
72 mL/min
Interval 57.7 to 86.3
87.8 mL/min
Interval 67.3 to 108.3
51.0 mL/min
Interval 24.4 to 77.6

SECONDARY outcome

Timeframe: 12 months post-transplant

Population: Kaplan- Meier

Outcome measures

Outcome measures
Measure
Delayed CNI Group 1
n=10 Participants
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
n=10 Participants
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
n=10 Participants
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Patient Survival
10 Participants
9 Participants
8 Participants

SECONDARY outcome

Timeframe: 12 months post transplant

Population: Kaplan Meier for patient survival

90% graft survival, related to the deaths of 3 patients during the study period.

Outcome measures

Outcome measures
Measure
Delayed CNI Group 1
n=10 Participants
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
n=10 Participants
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
n=10 Participants
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Graft Survival
10 Participants
9 Participants
8 Participants

SECONDARY outcome

Timeframe: 30 days

Acute Allograft Rejection

Outcome measures

Outcome measures
Measure
Delayed CNI Group 1
n=10 Participants
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
n=10 Participants
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
n=10 Participants
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Allograft Rejection Rates at 30 Days
3 Participants
1 Participants
0 Participants

Adverse Events

Delayed CNI Group 1

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Delayed CNI Group 2

Serious events: 1 serious events
Other events: 5 other events
Deaths: 1 deaths

Early CNI / Control Arm

Serious events: 1 serious events
Other events: 4 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Delayed CNI Group 1
n=10 participants at risk
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
n=10 participants at risk
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
n=10 participants at risk
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Respiratory, thoracic and mediastinal disorders
Metastatic Lung Cancer
0.00%
0/10 • 1 Year
10.0%
1/10 • Number of events 1 • 1 Year
0.00%
0/10 • 1 Year
Immune system disorders
Graft vs Host Disease
0.00%
0/10 • 1 Year
0.00%
0/10 • 1 Year
10.0%
1/10 • Number of events 1 • 1 Year
Cardiac disorders
Heart Failure
0.00%
0/10 • 1 Year
0.00%
0/10 • 1 Year
10.0%
1/10 • Number of events 1 • 1 Year

Other adverse events

Other adverse events
Measure
Delayed CNI Group 1
n=10 participants at risk
Thymoglobulin 3mg total, administered on Days 0 and 2 (after transplant), plus MMF and corticosteroids. CNI administration delayed until 10 days post transplant. tacrolimus 3-8 (trough concentration) Thymoglobulin 3mg total: 1.5 mg/kg induction on Day 0 and 1.5 mg/kg induction on Day 2 (total of 3 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Delayed CNI Group 2
n=10 participants at risk
Thymoglobulin 4.5mg total, plus MMF and corticosteroids. CNI therapy delayed until 10 days post transplant.tacrolimus 3-8 (trough concentration) Thymoglobulin 4.5mg total: 1.5 mg/kg induction on Days 0, 2 and 4 (total 4.5 mg/kg) Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 3-8: Trough concentration between 3 ng/mL and 8 ng/mL starting on Day 10 and continuing beyond Day 180
Early CNI / Control Arm
n=10 participants at risk
Standard post liver transplant therapy to include: tacrolimus 8-12 (trough concentration) initiated within 48 hours post-transplant, plus mycophenolate mofetil (MMF) and corticosteroids to be administered within 24 hours after transplant (Day 0). Mycophenolate mofetil: 1000 mg PO/IV BID for up to 6 months tacrolimus 8-12: Trough concentration between 8 ng/mL and 12 ng/mL on Days 0-10; between 6 ng/mL and 12 ng/mL on Days 10-30; between 6 ng/mL and 10 ng/mL Days 31-60; between 5 ng/mL and 8 ng/mL Days 61-179; and between 3 ng/mL and 8 ng/mL beyond Day 180.
Infections and infestations
HCV recurrence
20.0%
2/10 • Number of events 2 • 1 Year
50.0%
5/10 • Number of events 5 • 1 Year
40.0%
4/10 • Number of events 4 • 1 Year

Additional Information

Bijan Eghtesad

Cleveland Clinic

Phone: 2164029954

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place