PIONEER Trial (Post-Transplant Application of TruGraf and TRAC Molecular Panel in Renal Transplant Recipients)

NCT ID: NCT07231328

Last Updated: 2025-11-17

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 600 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-11-20
• Study Completion Date: 2029-03-31

Brief Summary

This is an observational, prospective, multi-center trial designed to evaluate clinical outcomes in kidney transplant recipients undergoing TruGraf and TRAC monitoring.

Approximately 15 U.S. sites

Detailed Description

All subjects who meet the inclusion criteria and none of the exclusion criteria will be eligible to participate. As the study is non-interventional, no protocol-mandated treatment or management plan will be imposed. In the absence of a universally ac-cepted paradigm for post-transplant monitoring with molecular diagnostics, participat-ing sites will be encouraged to follow their usual practice, supplemented where ap-propriate by the suggested TruGraf and TRAC™ algorithms.

To evaluate both the prognostic performance and the clinical utility of these bi-omarkers, a hybrid analytic framework will be used. Biomarker results will be made available to clinicians in real time, and investigators will prospectively record whether each result led to a change in clinical management. Natural History Subgroup: Test-ing events in which both TruGraf® and TRAC results are double-negative and no change in management occurred. Analyses will be anchored at the test-event level to avoid immortal time bias. This subgroup will be used to evaluate the safety and true negative predictive value (NPV) of a double-negative result, including the incidence of biopsy-proven acute rejection (BPAR) within 30 days.

• Real-World Use Subgroup: Testing events in which biomarker results prompt-ed a change in clinical management (e.g., change in immunosuppression, for-cause biopsy, or enhanced monitoring). By definition, any action following a test result places the event in this subgroup, irrespective of whether the bi-omarker result was double-negative or abnormal. Because clinical actions can alter subsequent risk trajectories, analyses in this subgroup will account for treatment-confounder feedback using causal modeling strategies (e.g., marginal structural models, target trial emulation).

Conditions

Immunosuppression Management; Biomarkers / Blood; Subclinical Rejection; Biopsy; Kidney Transplant Rejection

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: OTHER

Study Groups

Natural History Subgroup

There is no required Intervention for this Protocol. Based on Results for TruGraf/TRAC/TRAC ID Investigators may use the results in managing subjects Immunosuppression or rule out rejection.

Intervention Type: DIAGNOSTIC_TEST

Investigators will prospectively record whether each results led to a change in clinical management. Participating sites will be encouraged to follow their usual practice, supplemented where appropriate by the suggested TruGraf and TRAC™ TRAC ID algorithms

• Real-World Use Subgroup

There is no required Intervention for this Protocol. Based on Results for TruGraf/TRAC/TRAC ID Investigators may use the results in managing subjects Immunosuppression or rule out rejection.

Intervention Type: DIAGNOSTIC_TEST

Investigators will prospectively record whether each results led to a change in clinical management. Participating sites will be encouraged to follow their usual practice, supplemented where appropriate by the suggested TruGraf and TRAC™ TRAC ID algorithms

Interventions

There is no required Intervention for this Protocol. Based on Results for TruGraf/TRAC/TRAC ID Investigators may use the results in managing subjects Immunosuppression or rule out rejection.

Investigators will prospectively record whether each results led to a change in clinical management. Participating sites will be encouraged to follow their usual practice, supplemented where appropriate by the suggested TruGraf and TRAC™ TRAC ID algorithms

Intervention Type: DIAGNOSTIC_TEST

Eligibility Criteria

Inclusion Criteria

• Able to understand the key components of the study as described in the written informed consent document and willing and able to provide written informed consent.
• At least 18 years of age at the time of screening.
• Enrollment begins 30 days prior to transplant till day 29 post-transplantation.
• Recipient of a kidney transplant (either primary or repeat), from either deceased or living donor.
• Receiving any immunosuppressive regimen.
• Able and willing to comply with all study procedures, as assessed by the Investigator.
• Selected by the treating provider to undergo TruGraf and TRAC™ testing as part of routine post-transplant care

Exclusion Criteria

History of previous non-kidney solid organ, vascular composite allograft, pancreatic islet, stem cell, or bone marrow transplant.

• History of dual or en-bloc kidney transplants.
• Recipient or donor with positive test for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), hepatitis B virus (HBV) nucleic acid testing (NAT), hepatitis C virus (HCV) antibody, HCV NAT, human immunodeficiency virus (HIV), or HIV NAT.
• Patients known to be pregnant or with plans to become pregnant over the 24 months after enrollment.
• History or presence of coagulopathy, thrombophilia, unexplained bleeding or clotting disorders, or use of or documented plans for use of systemic anticoagulants at the time of screening, with the exception of uremic coagulopathy or prophylactic heparin preparations.
• History or presence, upon clinical evaluation, of any illness or condition that, in the opinion of the Investigator, would interfere with the ability to provide informed consent or comply with study instructions

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Medical University of South Carolina

OTHER

Sponsor Role: collaborator

Northwestern University

OTHER

Sponsor Role: collaborator

The Cleveland Clinic

OTHER

Sponsor Role: collaborator

University of Washington

OTHER

Sponsor Role: collaborator

University of California, Los Angeles

OTHER

Sponsor Role: collaborator

University of Nebraska

OTHER

Sponsor Role: collaborator

Duke University

OTHER

Sponsor Role: collaborator

University of Utah

OTHER

Sponsor Role: collaborator

Georgetown University

OTHER

Sponsor Role: collaborator

Virginia Commonwealth University

OTHER

Sponsor Role: collaborator

The Methodist Hospital Research Institute

OTHER

Sponsor Role: collaborator

Keck School of Medicine USC

UNKNOWN

Sponsor Role: collaborator

Weill Medical College of Cornell University

OTHER

Sponsor Role: collaborator

Erie County Medical Center

OTHER

Sponsor Role: collaborator

East Carolina University

OTHER

Sponsor Role: collaborator

AdventHealth

OTHER

Sponsor Role: collaborator

Transplant Genomics, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Isioma Agboli, MD

Role: STUDY_DIRECTOR

Transplant Genomics

Central Contacts

Isioma Agboli, Assistant Director, Clinical Programs, MD

Role: CONTACT

isioma.agboli@tgi.eurofinsus.com

510- 767-8609

Iulia Movileanu, Senior Clinical Trial Manager, MS CCRP

Role: CONTACT

Iulia.Movileanu@tgi.eurofinsus.com

315-720-7289

References

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Related Links

https://transplantgenomics.com/our-tests/kidney/trugraf-kidney/

Related Info

Other Identifiers

TGRP20_PIONEER

Identifier Type: -

Identifier Source: org_study_id