A Trial of Transplanting Hepatitis C Kidneys Into Hepatitis C-Negative Kidney Recipients

NCT ID: NCT04075916

Last Updated: 2025-10-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-22

Study Completion Date

2026-01-30

Brief Summary

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The Transplanting Hepatitis C Kidneys into Negative KidnEy Recipients \[THINKER-NEXT\] study will include adult kidney transplant candidates without hepatitis C virus (HCV) infection on the transplant waiting list who will consent to kidney transplantation from a deceased donor infected with HCV, followed by treatment with a direct acting antiviral. The one-year allograft function and one-year risk of CMV infection will be compared between THINKER-NEXT kidney transplant recipients and matched recipients who received hepatitis C uninfected kidney transplants (these patients are called Transplant Cohort). The survival rate of patients opting-in for offers of kidneys from HCV-viremic donors will be compared to the survival rate of matched comparators from the kidney transplant waitlist who did not consent to receive offers of a HCV-viremic kidney. Lastly, renal pathologic findings will be compared among HCV-viremic donors and HCV-negative comparator donors.

Detailed Description

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Conditions

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End Stage Renal Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Epclusa (sofosbuvir/velpatasvir)

Epclusa is taken by mouth for 12 weeks as per the FDA label.

Group Type EXPERIMENTAL

Epclusa

Intervention Type DRUG

All patients will receive 12 weeks of sofosbuvir/velpatasvir as per the FDA label.

Interventions

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Epclusa

All patients will receive 12 weeks of sofosbuvir/velpatasvir as per the FDA label.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Able to provide informed consent
* Active waiting list status for isolated kidney transplant
* 18 years of age or older
* No living kidney donor
* Panel reactive antibody (PRA) ≤97% (most recent cPRA at time of screening). Patients with a PRA of 98-100% at screening can be included unless patient has a most recent cytotoxic PRA of \>25% or calculated PRA \>50% where multiple moderate level HLA antibodies exist and in the opinion of the local site investigator represents substantial HLA sensitization. If patient has a PRA of 98-100%, the donor-recipient pair must meet additional eligibility criteria.

Exclusion Criteria

* Hepatocellular carcinoma
* Hepatitis B surface antigen and/or DNA positive
* Active Hepatitis C infection
* HIV RNA-positive or HIV antibody positive
* Other chronic liver disease (excluding non-alcoholic fatty liver disease \[NAFLD\] with normal liver enzymes)
* Persistently elevated liver transaminases (defined as the upper limit of normal at the reference laboratory)
* Advanced hepatic fibrosis or cirrhosis
* Primary Focal Segmental Glomerulosclerosis (FSGS), FSGS recurring in initial transplant, or other disease process at high risk of early graft failure per the treating transplant nephrologist
* Current use of amiodarone or dronedarone (due to interaction with sofosbuvir)
* Transplant candidate requires antibody desensitization protocol for transplantation
* Female who is pregnant, planning to become pregnant during the study, or breast-feeding
* Participation in another interventional study, from a period starting 6 months prior to screening to last study visit, that the study PIs judge would interfere with either the aims or the safety of the THINKER-NEXT study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gilead Sciences

INDUSTRY

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter Reese, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

University of Florida

Gainesville, Florida, United States

Site Status

Jackson Memorial Hospital/University of Miami

Miami, Florida, United States

Site Status

Johns Hopkins

Baltimore, Maryland, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

New York Presbyterian Hospital/Columbia University

New York, New York, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Vanderbilt University

Nashville, Tennessee, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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10067385

Identifier Type: -

Identifier Source: org_study_id

U01DK126654

Identifier Type: NIH

Identifier Source: secondary_id

View Link

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