Evaluation of the Efficacy of Dd-cfDNA in Routine Patient Care in Kidney Transplant Recipients"
NCT06406179 · Status: RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 500
Last updated 2025-09-05
Summary
The investigator hypothesizes that the combined use of (1) Donor-derived cell-free DNA (dd-cfDNA) in peripheral blood predicting anti-donor immunological activation or quiescence (2) interactive and actionable data analytics delivered at the bedside will promote safe clinical follow-up of kidney transplant patients with less need for invasive biopsy and less induced risk surveillance by allograft protocol biopsies to assess allograft rejection in clinically stable kidney transplant patients.
In addition, the evaluation of the transcriptional changes in tissue samples in selected patients using automated processing of digital slide images and intragraft gene expression profiles will provide a better diagnosis of the rejection mechanisms to provide the best therapeutic approach as compared to current clinical practice.
We therefore propose a French, multicenter, prospective randomized trial comparing two strategies of follow-up: in the first group, a biopsy is performed at M3, M12 and for clinical indication whenever considered necessary by the clinician during the first 18 months of follow-up after transplant. In the second group, patients will have the same follow-up as in the first group, but reports providing dd-cfDNA results and relevant medical parameters will be provided to the physician to help him in the decision to perform a biopsy or not.
Conditions
- Renal Transplantation
Interventions
- BIOLOGICAL
-
dd-cfDNA-guided
In groups I and II, the blood sample for dd-cfDNA assay will be taken on D0, just prior to transplantation, for all patients. in addition, for patients following a dd-cf DNA-guided strategy based on dd-cf DNA ; samples for dd-cf DNA assay will be taken at M3 and M12 visits and at visits for clinical indication (5 maximum) and the blood will be sent to the PARCC technical platform of INSERM UMR 970. By combining the dd-cfDNA level and relevant medical data, an integration report will be sent to the centers to stratify patients into high-risk or low-risk rejection profiles. If the patient is classified in the "low risk of rejection" subgroup, he may decide not to perform the biopsy. If the patient is classified in the "high risk of rejection" subgroup, he may decide to perform the biopsy within 15 days of the sample being taken. the decision to perform the biopsy is left to the discretion of the physician.
Sponsors & Collaborators
-
Assistance Publique - Hôpitaux de Paris
lead OTHER
Principal Investigators
-
Alexandre Loupy, PR · APHP
Study Design
- Allocation
- RANDOMIZED
- Purpose
- DIAGNOSTIC
- Masking
- NONE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2025-05-31
- Primary Completion
- 2028-11-30
- Completion
- 2028-11-30
Countries
- France
Study Locations
More Related Trials
-
Dd-cfDNA and Treg in Prediction of Kidney Transplant Acute Rejection
NCT05084768 ·Status: RECRUITING
-
ddcfDNA in Kidney Transplant Recipients
NCT06013358 ·Status: UNKNOWN
-
Expanding the Scope of Post-transplant HLA-specific Antibody Detection and Monitoring in Renal Transplant Recipients
NCT06025240 ·Status: RECRUITING
-
TTV-based mAnagement Of Long-term ImmunosuppreSsion in Kidney Transplantation
NCT06829719 ·Status: RECRUITING ·Phase: NA
-
Non Invasive Blood Test To Diagnose Acute Rejection After Kidney Transplantation
NCT02424227 ·Status: UNKNOWN
-
DE NOVO DONOR SPECIFIC ANTIBODIES AFTER KIDNEY TRANSPLANTATION: SINGLE-CENTER RETROSPECTIVE STUDY
NCT06425497 ·Status: COMPLETED
-
Molecular Biological and Moleculargenetic Monitoring of Therapy After Kidney Transplantation
NCT01515605 ·Status: RECRUITING
-
Detection of Circulating Kidney DNA in Kidney Transplant Patients Facing an Episode of Graft Rejection
NCT06351488 ·Status: RECRUITING
-
Donor-derived Cell-free DNA for Early Diagnosis of Antibody-mediated Rejection
NCT04897438 ·Status: COMPLETED ·Phase: NA
-
Immunosuppression's Long Term Impact on Anti-tumoral Oversight in Kidney Transplantation
NCT03227965 ·Status: COMPLETED ·Phase: NA
-
Assessment of T-cell Response and In-vitro Proof-of-concept of T-cell Engineering in Chronic ESKD Patients.
NCT06474169 ·Status: RECRUITING
-
PApillomavirus in REnal Transplant Patient
NCT02845739 ·Status: COMPLETED ·Phase: NA
-
A Multicenter, Prospective Blood Collection Study in a Kidney Transplant Population
NCT07006831 ·Status: RECRUITING
-
Study of Alloimmune Response in Humoral Rejection After Kidney Transplantation
NCT05890430 ·Status: NOT_YET_RECRUITING
-
Study of Tolerant Kidney Transplant Recipients
NCT01338779 ·Status: COMPLETED
-
Non-Invasive Monitoring of Pediatric Kidney Transplant Recipients and Immunosuppression Personalization: an Open-labeled Multicenter Randomized Controlled Study
NCT06761482 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
Study in Detection cfDNA for the Early-stage Diagnosis of Acute Rejection Post-renal Transplantation
NCT03759535 ·Status: UNKNOWN
-
AlloSure for the Monitoring of Antibody Mediated Processes After Kidney Transplantation
NCT04057742 ·Status: COMPLETED
-
Validation of Donor-Derived Cell-Free DNA (Dd-cfDNA) for Kidney Transplant Monitoring
NCT07060716 ·Status: RECRUITING
-
Study of Specific CD4 Tumors Th1 Responses in Renal Transplant After Occurrence of Cancer
NCT02843763 ·Status: UNKNOWN ·Phase: NA
-
Assessing AlloSure Dd-cfDNA Monitoring Insights of Renal Allografts With Longitudinal Surveillance
NCT04566055 ·Status: UNKNOWN
-
Re-evaluation of Donor-specific Anti-HLA Alloantibodies Immunoassay After Organ Transplantation, From Antigen Level to Epitope Level
NCT03861962 ·Status: UNKNOWN
-
Eliminating the Need for Pancreas Biopsy Using Peripheral Blood Cell-free DNA
NCT04166149 ·Status: COMPLETED
-
Analysis of Donor-derived Cell Free DNA in Liver Transplant Patients
NCT06225206 ·Status: RECRUITING
-
Impact of Anti-HLA Donor-specific Antibodies in ABO-incompatible Kidney Transplantation
NCT03423901 ·Status: COMPLETED ·Phase: NA