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Evaluation of Thymoglobulin Induction and Reduced Doses of Calcineurin Inhibitors on Liver Transplant Rejection

Phase 2
Completed
Conditions
Rejection, Transplant
Transplantation, Liver
Liver Dysfunction
Interventions
Drug: Corticosteroid
Biological: Thymoglobulin
Registration Number
NCT00117689
Lead Sponsor
Genzyme, a Sanofi Company
Brief Summary

This study involves the use of a drug called Thymoglobulin, which is approved in the US to treat kidney transplant rejection and in Canada to treat and prevent kidney transplant rejection. This study will evaluate the effect of Thymoglobulin induction therapy and reduced doses of calcineurin inhibitors on the incidence of liver rejection and will provide a basis for future evaluations of Thymoglobulin as an immunosuppressive agent to help decrease the incidence of liver transplant rejection. Subjects meeting all inclusion and exclusion criteria are eligible to participate in this study. Approximately 75 study subjects from up to 18 transplant centers in the United States and Canada will be enrolled in this 12-month study.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
75
Inclusion Criteria
  • Primary liver transplant recipient with Model for End-Stage Liver Disease (MELD) criteria documentation
  • Serum creatinine > 1.5mg/dL at the time of transplant, or based on the value used to calculate the most recent pre-operative MELD Score for liver allocation
  • Ages greater than or equal to 18 years
  • If female, must not be lactating; must have a negative serum beta-human chorionic gonadotropin (HCG) test within 7 days prior to Study Day 0 (Day of Transplant); and must agree to practice an acceptable and reliable form of contraception during the study
  • Signed informed consent
Exclusion Criteria
  • Living donor or multiple organ transplants
  • Prior solid organ or bone marrow transplant recipient
  • Fulminant hepatic failure
  • Status 1 transplants
  • ABO incompatible transplants
  • Transplants utilizing livers from non heart-beating donors
  • Liver transplant candidates with > 6 weeks of analysis
  • Donor with positive serology for hepatitis B surface antigen (HBsAg)
  • Evidence of human immunodeficiency virus (HIV)
  • Autoimmune hepatitis
  • History of chronic steroid or immunosuppressant use in the 90 days prior to transplant, except for inhaled corticosteroids to treat asthma
  • Recipient of investigational therapy within 90 days prior to transplant procedure
  • Known contraindication to administration of rabbit anti-thymocyte globulin
  • Acute viral illness
  • History of malignancy within 5 years, with the exception of adequately treated localized squamous or basal cell carcinoma of the skin without evidence of recurrence, and/or hepatocellular carcinoma
  • Illness other than primary liver disease (e.g. severe ischemic heart disease, left ventricular dysfunction, or pulmonary disease), which, in the opinion of the investigator, may significantly increase the risk of the transplantation procedure
  • Current drug and alcohol abuse that, in the opinion of the investigator, puts subjects at risk for poor compliance (no drug test required)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2 Standard of CareCorticosteroidThymoglobulin with tacrolimus and corticosteroid sparing maintenance therapy
1ThymoglobulinStandard (tacrolimus based standard therapy without induction)
2 Standard of CareMycophenolate MofetilThymoglobulin with tacrolimus and corticosteroid sparing maintenance therapy
1TacrolimusStandard (tacrolimus based standard therapy without induction)
1Mycophenolate MofetilStandard (tacrolimus based standard therapy without induction)
2 Standard of CareTacrolimusThymoglobulin with tacrolimus and corticosteroid sparing maintenance therapy
Primary Outcome Measures
NameTimeMethod
Freedom from biopsy-proven acute rejection (including humoral rejection)6 months
Secondary Outcome Measures
NameTimeMethod
Explore the impact of Thymoglobulin on the prevention of liver transplant rejection, transplanted liver loss, death, and safety of Thymoglobulin after transplant.12 months
Explore the impact of Thymoglobulin on kidney function after transplant6 months

Trial Locations

Locations (16)

University of Alabama, Birmingham

🇺🇸

Birmingham, Alabama, United States

USC University Hospital

🇺🇸

Los Angeles, California, United States

University of California, San Fransisco Hospital

🇺🇸

San Francisco, California, United States

University of Colorado Hospital and Health Sciences Center

🇺🇸

Denver, Colorado, United States

Mayo Clinic Jacksonville

🇺🇸

Jacksonville, Florida, United States

University of Miami

🇺🇸

Miami, Florida, United States

Fairview University Medical Center

🇺🇸

Minneapolis, Minnesota, United States

Washington University Medical Center

🇺🇸

St. Louis, Missouri, United States

University of Nebraska

🇺🇸

Omaha, Nebraska, United States

Mount Sinai Medical Center

🇺🇸

New York, New York, United States

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University of Alabama, Birmingham
🇺🇸Birmingham, Alabama, United States

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