A Study of Thymoglobulin and Tacrolimus in Liver Transplant

Phase 4

• Conditions: Liver Transplantation; Liver Disease; Immunosuppression
• Interventions: Drug: tacrolimus; Drug: anti-thymocyte globulin (rabbit)

• Registration Number: NCT00564538
• Lead Sponsor: University of Nebraska

Brief Summary

The purpose of this study is to compare kidney function, long term patient and graft survival, and incidence of acute rejection in liver transplant recipients between one group receiving thymoglobulin induction and delayed initiation of tacrolimus and another group of liver transplant recipients having immediate administration of tacrolimus without any induction immunosuppression.

Detailed Description

Renal insufficiency following liver transplantation in adult recipients is a major cause of morbidity and a major contributor to mortality. One of the key factors contributing to this renal dysfunction is the use of calcineurin inhibitors. There is some evidence to suggest that the first 7-10 days following liver transplantation are crucial in terms of renal function and the ability to avoid the use of nephrotoxic agents such as calcineurin inhibitors may have a significant impact on long-term outcome.

Study Timeline

• Status Verified: 2007-11
• Study First Submitted: 2007-11-27
• Study First Submitted QC: 2007-11-27
• Last Update Submitted: 2007-11-27
• Study First Posted: 2007-11-28
• Last Update Posted: 2007-11-28
• Study Start: 2007-12
• Study Completion: 2009-12

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

• Primary liver transplant recipient with Model for End Stage Liver Disease (MELD) criteria documentation
• Over 18 years of age
• Signed informed consent form
• if female of childbearing potential: Must not be lactating Must have negative serum pregnancy test on study day 0 Must have agreed on a reliable and acceptable form of contraception during the study
• sexually active males must be practicing an acceptable form of contraception

Exclusion Criteria

• Multiple organ transplants
• Prior solid organ or bone marrow transplant recipients
• Fulminant hepatic failure
• Status 1 transplants
• Liver transplant candidates with greater than 6 weeks of dialysis
• Patients who in the opinion of the Investigator are not eligible for thymo induction at the time of transplant
• Recipients of investigational therapy within 90 days prior to transplant
• Know contraindication to administration of rabbit anti-thymocyte globulin
• Patients whose medical condition is such that the physician feels it would not be in their best interest to participate in the study
• Patients who are unwilling to have a Glofil nuclear medicine scan at specified time points
• 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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
2	tacrolimus	patients in arm 2 will not receive thymo induction at time of transplant and will have immediate initiation of tacrolimus
1	anti-thymocyte globulin (rabbit)	Patients in arm 1 will receive induction with thymoglobulin at time of transplant with delayed initiation of tacrolimus

Primary Outcome Measures

Name	Time	Method
Evaluation of renal function via Glo-Fil nuclear medicine scan and laboratory parameters	Post operative day #1, month 6 and month 12

Secondary Outcome Measures

Name	Time	Method
patient and graft survival, incidence of acute rejection, incidence of active CMV disease, incidence of other infections, any adverse events or serious adverse events associated with the use of thymo induction therapy	post op days 1-6, months 3,6, 9, and 12

Trial Locations

Locations (1)

University of Nebraska Medical Center; 🇺🇸 Omaha, Nebraska, United States