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Anti-T-Lymphocyte Globulin (ATG) in Renal Transplantation of Kidneys With a Non-Heart-Beating (NHB) Donor

Phase 3
Conditions
Renal Transplant Patients
Recipients of a Kidney From a Non-Heart-Beating Donor
Interventions
Registration Number
NCT00733733
Lead Sponsor
Radboud University Medical Center
Brief Summary

One of the greatest problems in renal transplantation is the shortage of donor kidneys. Kidneys of non-heart-beating donors (NHB) are a possible solution, but transplantation is accompanied with a high percentage of acute renal failure, caused by ischemia-reperfusion injury. The increased ischemia-reperfusion injury results in an increased immune activation, which can lead to more injury of the kidney and additional acute rejections. The hypothesis of this trial is that ischemia-reperfusion injury can be diminished by ATG. ATG could have additional favourable effects. To investigate this half of the patients is treated with additional ATG to the standard immunosuppressive treatment. Calcineurin inhibitors are not diminished during the first days after transplantation to investigate whether ATG has special effects on ischemia-reperfusion injury.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
180
Inclusion Criteria
  • Non-heart-beating-donors (Maastricht III/IV)
  • Female patients of childbearing age agree to maintain effective birth control practice during the study.
Exclusion Criteria
  • Pregnant or lactating women at the time of randomization.
  • Patients and donors are ABO incompatible.
  • Women having had >3 pregnancies (including abortions if no consistent data on PRA or anti-donor antibodies are available).
  • Patients with hypersensibility to rabbit proteins, previous treatment with rabbit IgG, or known intolerance to any component of basal immunosuppression.
  • Patients with leukocytes <3,000/mm3 and/or platelets <50,000/mm3 before initiation of transplant.
  • Patients, who are HIV positive.
  • Patients subjected to previous transplants or candidates for multiple transplants (e.g. SKP).
  • Patients, who are unlikely to comply with the visit schedule in the protocol and patients who cannot communicate reliably with the investigator.
  • Patients with pulmonary oedema or with other signs of overhydration.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ATGATG FreseniusOne gift of ATG Fresenius (9 mg/kg body weight) intravenously during the transplantation procedure. ATG is given in addition to standard immunosuppressive treatment (tacrolimus/MMF/prednisolone)
Primary Outcome Measures
NameTimeMethod
Incidence of initial delayed graft function (defined as need for dialysis)Within three months after transplantation
Secondary Outcome Measures
NameTimeMethod
Duration of initial delayed graft failureWithin 3 months after transplantation
Incidence of primary never-functioning graftsWithin 3 months after transplantation
Incidence of acute rejections (biopsy proven)Within 3 months after transplantation
Renal function as determined by MDRDAt 1, 2, 3 months after transplantation
ProteinuriaAt 1, 2, 3 months after transplantation
Percentage of patients with arterial hypertensionAt 3 months after transplantation
Percentage of patients with antihypertensive drugs (and the number of different classes of antihypertensive drugs)At 3 months after transplantation
Percentage of hyperlipidemic patientsAt 3 months after transplantation
Percentage of post transplant diabetes mellitusDuring 3 months after transplantation
Incidence of cytomegalovirus infectionDuring 3 months after transplantation
Incidence of tumours/PTLDAt 3 months after transplantation
Patient and graft survivalAt 3 months after transplantation
Incidence of other infectionsDuring 3 months after transplantation
MicroalbuminuriaAt 1, 2, 3 months after transplantation

Trial Locations

Locations (1)

UMC St Radboud Hospital

🇳🇱

Nijmegen, Netherlands

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