Withdrawal of Immunosuppression in Long Term Stable Liver Transplant Recipients (tolerance)
Recruitment status was Recruiting
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Purpose
Long-term immunosuppression carries potential adverse effects such as risk of infection, malignancy, renal insufficiency, diabetes and hypertension. In clinical liver transplantation, some liver transplant recipients maintain allograft function without immunosuppressive drugs. This is called as "operational tolerance". Many attempts have been made to identify immunological biomarkers predicting operational tolerant patients. Therefore, the investigators aimed to identify patients who have the potential to be operationally tolerant using biomarkers, withdraw immunosuppressant gradually and stop ultimately with monitoring of biomarkers.
| Condition | Intervention | Phase |
|---|---|---|
|
Liver Transplantation |
Procedure: immunosuppression withdrawal Procedure: continue of taking immunosuppressant |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Gradual Withdrawal of Immunosuppression in Long Term Stable Liver Transplant Recipients Using Immunologic Profile Predicting Operational Tolerance |
- number of participants who have the potential for the operational tolerance [ Time Frame: in the 2 years fololowing study enrollment ] [ Designated as safety issue: Yes ]measure number of patients who can be weaned off immunosuppression completely
- Tolerance biomarker [ Time Frame: 1 year following immunosuppression withdrawal ] [ Designated as safety issue: No ]find out biomarkers which can predict operational tolerance
- immunologic profile related to rejection [ Time Frame: up to 2 years following withdrawal of immunosuppression ] [ Designated as safety issue: No ]observe immunologic profile changes which are related to rejection
| Estimated Enrollment: | 20 |
| Study Start Date: | July 2010 |
| Estimated Study Completion Date: | March 2013 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: LT, withdrawal of immunosuppression |
Procedure: immunosuppression withdrawal
tapering off immunosuppressant
Other Name: WIS
|
| Active Comparator: LT, maintenance of immunosuppression |
Procedure: continue of taking immunosuppressant
maintain immunosuppression
Other Name: MIS
|
Detailed Description:
Among long term stable liver transplant recipients, we will select some proportion of patients who have the high potential for obtaining operational tolerance using biomarkers.
Then, we will gradually reduce immunosuppressants and monitor biomarkers as well as biochemical tests. The course of tapering off immunosuppressant will take about 1 year.
During withdrawal of immunosuppression, participants will be closely monitored for liver enzyme, immunological profile.
If there are some signs of rejection, liver biopsy will be undertaken and participants will be treated using immunosuppressant.
After complete withdrawal of immunosuppressant, participants will be followed for at least of 1 year.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- long term stable liver transplant recipients
Exclusion Criteria:
- liver transplant due to autoimmune disease
- liver transplant due to hepatitis C virus (HCV)
- history of graft rejection
- history of biliary infection or stricture
Contacts and Locations| Contact: Jong Young Choi, Professor | 82-2-2258-2073 | jychoi@catholic.ac.kr |
| Korea, Republic of | |
| Seoul St. Mary's Hospital | Recruiting |
| Seoul, Korea, Republic of, 137-040 | |
| Contact: Jong Young Choi, Professor 82-2-2258-2073 jychoi@catholic.ac.kr | |
| Study Chair: | Jong Young Choi, Professor | The Catholic University of Korea |
More Information
Publications:
| Responsible Party: | liver transplantation unit, Seoul St. Mary's Hospital |
| ClinicalTrials.gov Identifier: | NCT01198314 History of Changes |
| Other Study ID Numbers: | CMCLTIT, A092258-0911-1030100 |
| Study First Received: | September 7, 2010 |
| Last Updated: | September 9, 2010 |
| Health Authority: | Korea: Institutional Review Board |
Keywords provided by The Catholic University of Korea:
|
long term stable recipients |
Additional relevant MeSH terms:
|
Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013