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Liver Transplantation With Tregs at MGH
Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)
Summary
This is a single-center, prospective, open-label, non-randomized clinical trial exploring cellular therapy to facilitate immunosuppression withdrawal in liver transplant recipients.
Official title: A Phase I/II Drug Withdrawal Study of Alloantigen-Specific Tregs in Liver Transplantation (ITN073ST)
Key Details
Gender
All
Age Range
18 Years - 70 Years
Study Type
INTERVENTIONAL
Enrollment
9
Start Date
2019-03-29
Completion Date
2027-04-06
Last Updated
2025-01-13
Healthy Volunteers
No
Conditions
Interventions
arTreg-CSB
Participants will receive a single dose of Treg product (arTreg-CSB). The target dose is 2.5 to 125 x 10\^6 total cells. If a minimum arTreg-CSB dose of 1 to \< 2.5 x 10\^6 cells, the product will be infused. If the dose obtained after product manufacture is \< 1 x 10\^6 cells, the product will not be infused. When the dose obtained after product manufacture is \> 125 x 10\^6 cells, a dose aliquot will be prepared so that the administered dose will be ≤ 125 x 10\^6 cells, and ≥ 2.5 to 125 x 10\^6 total cells. Method of receipt: peripheral intravenous (IV) infusion, administered over 15 to 30 minutes.
leukapheresis
Leukapheresis will be the method employed to recover peripheral blood mononuclear cells (PBMCs) from the allograft recipient. The recipient will undergo the procedure prior to initiating the cyclophosphamide conditioning regimen. Procedure 72 to 120 hours prior to Treg product (arTreg-CSB) IV infusion.
cyclophosphamide
40 mg/kg administered intravenously (IV) within 24 to 72 hours prior to Treg product (arTreg-CSB) infusion.
mesna
Mesna is administered intravenously to inhibit hemorrhagic cystitis induced by cyclophosphamide. Administration of mesna is per institutional practice with cyclophosphamide.
everolimus
EVR, an immunosuppressant (IS), is approved by the FDA for the prophylaxis of allograft rejection in adults receiving a liver transplant. Between day 30 and wk. 48 post-transplant, participant evaluation for eligibility to be converted to an EVR-based IS regimen will occur. At the start of conversion from tacrolimus (TAC) to EVR IS:EVR will be started at 1.5 mg taken by mouth BID, with dose adjusted to achieve a trough blood level of 5-8 ng/mL. Once an EVR trough level of ≥ 5 ng/mL is achieved, baseline TAC dose will be reduced to achieve a trough level of 3-5 ng/mL. When target EVR and TAC levels are achieved/ maintained over two consecutive measurements, and liver function tests, ALT and GGT, are ≤50 U/L, participants will be considered successfully converted to EVR-based IS regimen. EVR doses will be administered, monitored and adjusted over time, per protocol.
Locations (1)
Massachusetts General Hospital: Transplantation
Boston, Massachusetts, United States