Non-Invasive Monitoring of Pediatric Kidney Transplant Recipients and Immunosuppression Personalization: an Open-labeled Multicenter Randomized Controlled Study

NCT ID: NCT06761482

Last Updated: 2025-01-07

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-01

Study Completion Date

2029-03-01

Brief Summary

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Currently, the monitoring of children receiving a kidney transplantation includes surveillance biopsies to detect subclinical rejection and signs of toxicity of immunosuppressive drugs (tacrolimus).

The hypothesis of the study is that the combination of non-invasive biomarkers (Donor-derived cell-free DNA and Virus-specific T cells) will allow both the safe discontinuation of surveillance biopsies and the personalization of the exposure to calcineurin inhibitors among pediatric kidney transplant recipients.

Detailed Description

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MONITOR is an open label multicenter prospective randomized trial of superiority with two active comparators (4 parallel groups 1:1:1:1).

Arm A: monitoring by dd-cfDNA; Arm B: monitoring by T-Vis; Arm C: monitoring by dd-cfDNA+ T-Vis; Comparator arm: Current standard of care based on surveillance biopsies and biological monitoring

Main objectives and primary endpoints :

1. To demonstrate that the use of an integrative score of allograft rejection including dd-cfDNA measurement allows the reduction of the number of surveillance biopsies.

Endpoint: Number of biopsy performed in each arm
2. To demonstrate that steering immunosuppression based on Tvis numbers allows the reduction of the exposition to calcineurin inhibitors.

Endpoint: Tacrolimus exposure assessed as the mean of the residual concentration of Tacrolimus between M6 and M24

Conditions

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Pediatric Kidney Disease Transplant;Failure,Kidney

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

An open label multicenter prospective randomized trial of superiority with two active comparators / 4 groupes : monitoring by dd-cfDNA; monitoring by T-Vis; monitoring by dd-cfDNA+ T-Vis; Current standard of care based on surveillance biopsies and biological monitoring
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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monitoring by dd-cfDNA

Group Type EXPERIMENTAL

monitoring by dd-cfDNA

Intervention Type PROCEDURE

monitoring by dd-cfDNA

monitoring by T-Vis

Group Type EXPERIMENTAL

monitoring by T-Vis

Intervention Type PROCEDURE

monitoring by T-Vis

monitoring by dd-cfDNA and T-Vis

Group Type EXPERIMENTAL

monitoring by dd-cfDNA+ T-Vis

Intervention Type PROCEDURE

monitoring by dd-cfDNA+ T-Vis

Current standard of care based on surveillance biopsies and biological monitoring

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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monitoring by dd-cfDNA

monitoring by dd-cfDNA

Intervention Type PROCEDURE

monitoring by T-Vis

monitoring by T-Vis

Intervention Type PROCEDURE

monitoring by dd-cfDNA+ T-Vis

monitoring by dd-cfDNA+ T-Vis

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age less than 21 years old at transplantation
* Single renal transplant from a deceased or a living donor.
* Absence of pregnancy confirmed by a negative pregnancy test in women in child-bearing period.
* Subject and legal guardians are willing and able to provide signed written informed consent and to comply with the study procedures
* Patients affiliated to health insurance system including Aide Médicale de l'Etat (AME)

Exclusion Criteria

* History of multi-organ transplant (interference with rejection natural history)
* No surveillance biopsy planned
* Adult patient (or legal guardians) with limited understanding of the French language preventing him from receiving informed information on the protocol
Minimum Eligible Age

1 Year

Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Julien HOGAN, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Locations

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Robert Debré Hospital

Paris, , France

Site Status

Countries

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France

Central Contacts

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Julien HOGAN, MD, PhD

Role: CONTACT

+331 40 03 21 42

Facility Contacts

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Julien HOGAN, MD, PhD

Role: primary

+331 40 03 21 42

Other Identifiers

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IDRCB 2024-A01418-39

Identifier Type: REGISTRY

Identifier Source: secondary_id

APHP230817

Identifier Type: -

Identifier Source: org_study_id

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