Impact of ExtraCorporeal Phototherapy (ECP) on Auxiliary Follicular T-lymphocytes and Circulating B-lymphocytes During Chronic AntiBody-Mediated Rejection in Kidney Transplantation.

NCT ID: NCT04870437

Last Updated: 2025-10-01

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

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-27

Study Completion Date

2026-06-01

Brief Summary

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Chronic AntiBody-Mediated Rejection (cABMR) is the leading cause of late kidney transplant loss (after 1 year of kidney transplantation). Its therapeutic management is poorly codified and there is currently no treatment referring.

Extracorporeal phototherapy (ECP) is a therapeutic apheresis that involves purifying mononucleated cells in the blood, exposing them to UltraViolet A (UVA) and re-injecting them to the patient. This treatment is used as common care in the first line as part of the treatment of cutaneous T lymphoma and in the second line as part of the graft versus host reaction after bone marrow allograft.

The mechanisms underlying the action of the ECP are not well known. They are mediated by the reinjection of cells exposed to UVA which enter apoptosis and induce immunomodulation. Recent work during cABMR shows that TFH lymphocytes, the maturing population of B lymphocytes, are deregulated and activated.

The hypothesis is that ECP can modulate T Follicular Helper (TFH) lymphocytes during cABMR.

Detailed Description

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Conditions

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Kidney Transplantation

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Extracorporeal phototherapy

Group Type EXPERIMENTAL

Extracorporeal phototherapy

Intervention Type OTHER

The principle of ECP is to collect mononucleated cells from the blood by centrifugation. After purification, the mononucleated cells are incubated ex-vivo with a photo-activatable DNA intercalating agent (8-methoxypsoralen, UVADEX®), then re-injected to the patient.

Interventions

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Extracorporeal phototherapy

The principle of ECP is to collect mononucleated cells from the blood by centrifugation. After purification, the mononucleated cells are incubated ex-vivo with a photo-activatable DNA intercalating agent (8-methoxypsoralen, UVADEX®), then re-injected to the patient.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ECP treatment decision based on transplant team habits (care management)
* Age ≥ 18 years
* Affiliation to a French social security scheme
* Kidney transplant at least 6 months prior to inclusion
* cABMR proven by a renal graft biopsy less than 3 months and meeting the following histological criteria:

* allograft glomerulopathy (cg\>0, and maximum score cg2) or intimal fibrosis
* C4d positive or ptc+g greater than or equal to 2
* Presence of Donor Specific Antibody (DSA)
* Interstitial Fibrosis and Tubular Atrophy (IFTA) less than or equal to 2
* Glomerular filtration rate \> 30 mL/min/1.73 m2
* Signed informed consent to participate in the study

Exclusion Criteria

* Active infection or infection with hepatitis B, C or HIV virus
* Pregnant, breastfeeding or parturient woman
* Person deprived of liberty by judicial or administrative decision
* Person receiving psychiatric care under duress
* Person subject to legal protection
* Person out of state to express consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Therakos

INDUSTRY

Sponsor Role collaborator

University Hospital, Angers

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Chu Besancon

Besançon, , France

Site Status RECRUITING

CHU Clermont Ferrand

Clermont-Ferrand, , France

Site Status RECRUITING

Chu Saint Etienne

Saint-Etienne, , France

Site Status RECRUITING

CHU de STRASBOURG

Strasbourg, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Jean-François AUGUSTO, Pr

Role: CONTACT

+33 2 41 35 50 63

Emma BLANCHET

Role: CONTACT

+33 2 41 35 63 38

Facility Contacts

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DIDIER DUCLOUX, DR

Role: primary

+3381219220

ANNE ELISABETH HENG, DR

Role: primary

+33473751427

CHRISTOPHE MARIAT, DR

Role: primary

+33477828380

SOPHIE CAILLARD OHLMANN, DR

Role: primary

Other Identifiers

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2021-A00580-41

Identifier Type: -

Identifier Source: org_study_id

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