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Opportunistic InfectionsSIMPLICITYNCT03083756

Validation of a Risk Score Opportunistic Infections Development in Kidney Transplant Patients

An observational study of Opportunistic Infections, run by Sociedad Española de Trasplante at 15 sites in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study validate the usefulness of SIMPLICITY score to characterize the immune status of the kidney transplant receiver at two points along its course (the one and six months after transplantation), by determination in peripheral blood of various parameters related to cellular immunity (count subpopulations of CD3+… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Opportunistic Infections
How many people
577 participants
Where
15 sitesSpain
Study dates
Aug 2014to 15 Feb 2017
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Renal transplant patients

Who may be able to join

  • Renal transplant patients whose variables can be properly monitored throughout the first year post-transplant.
  • Older than 18 years.
  • Patients who have signed the informed consent form.

Who cannot join

  • Infection with the human immunodeficiency virus (HIV).
  • Patient who dies during the first month after transplant.
  • Pre-transplant diagnosis of primary immunodeficiency (eg. Common variable immunodeficiency, idiopathic CD4 lymphopenia, etc)
  • Patient is participating in another clinical trial with a molecule under investigation.

Trial locations and contacts

15 sites in 1 country.

15 sites in 1 country

Spain15 sites
  • Complejo Hospitalario Universitario A Coruña

    A Coruña, A Coruña, 15006

  • Hospital del Mar

    Barcelona, Barcelona, 08003

  • Hospital Vall d´Hebrón

    Barcelona, Barcelona, 08035

  • Hospital Clinic de Barcelona

    Barcelona, Barcelona, 08036

  • Hospital Universitario Virgen de la Arrixaca

    El Palmar, Murcia, 30120

  • Hospital Dr. Negrín

    Las Palmas de Gran Canaria, La Palmas, 35010

  • Hospital Ramón y Cajal

    Madrid, Madrid, 28034

  • Hospital Universitario 12 Octubre

    Madrid, Madrid, 28041

  • Hospital Universitario Puerta de Hierro Majadahonda

    Majadahonda, Madrid, 28222

  • Hospital Carlos Haya

    Málaga, Málaga, 29010

  • Hospital Son Espases

    Palma de Mallorca, Balearic Islands, 07120

  • Hospital Marqués de Valdecilla

    Santander, Cantabria, 39008

  • Hospital Virgen de la Salud

    Toledo, Toledo, 45071

  • Hospital Universitario Doctor Peset

    Valencia, Valencia, 46017

  • Hospital Miguel Servet

    Zaragoza, Zaragoza, 50009

Other trials in Spain

About this study

Official title: Prospective Observational Study for the Validation of a Risk Score Opportunistic Infections Development in Kidney Transplant Patients

This study validate the usefulness of SIMPLICITY score to characterize the immune status of the kidney transplant receiver at two points along its course (the one and six months after transplantation), by determination in peripheral blood of various parameters related to cellular immunity (count subpopulations of CD3+ (cluster of differentiation 3), CD4+ (cluster of differentiation 4) and CD8+( cluster of differentiation 8)), humoral immunity (immunoglobulins count) and innate (complement).

Read the detailed description

The monitoring of various parameters related to cellular and humoral immunity (lymphocytes, immunoglobulins and complement) through a score (SIMPLICITY) (8) would allow the identification of renal transplant recipients at high risk for post-transplant infection. Prolonged or prolonged use of CMV (Cytomegalovirus) prophylaxis may modify this risk.

The SIMPLICITY score (Seeking for Immune Status based on Peripheral Blood Lymphocytes, Immunoglobulins and Complement Activity) is a practical score based on the monitoring of readily available immunological parameters to assess the risk of infection after RT (Renal transplant). In order to perform this score, the total lymphocyte counts and peripheral blood lymphocyte subpopulations (PBLSs), serum immunoglobulin levels (IgG, IgA (Immunoglobulin A) and IgM) and serum complement levels (C3 and C4) at baseline were investigated, at one month and 6 months after transplantation.

The validation of this new score would allow to have a weapon that would lead to reduce to the maximum the pharmacological immunosuppression and to use strict prophylactic measures in these patients.

The results of the present study may provide insight into clinically and scientifically relevant aspects of infection in the recipient of an RT undergoing immunosuppressive therapy:

From the point of view of assistance, if the hypothesis of the study were confirmed, the possibility of elaborating specific strategies of prophylaxis and early treatment (antibiotic, antifungal or antiviral), adjusted to the risk of the recipient to present some infectious event during its evolution post transplantation according to the SIMPLICITY score.

Likewise, it could lay the foundations for the design of individualized immunosuppression guidelines, in which the risk of infectious complications could be evaluated jointly with that of graft rejection. And all this based on simple immunological parameters, of economic determination and accessible for most of the centers of our environment, circumstance that would favor its immediate application in the usual clinical practice.

Given that the literature on this line of research is scarce, and the hypothesis we intend to demonstrate is novel and conceptually attractive, the results of this study will be able to be published in journals with a high impact index in the field of immunology and Management of infectious complications in the RT.

Medical subject headings
Opportunistic Infections

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. To validate SIMPLICITY Score to characterize the immunological situation of the RT recipient at month of transplantation).

    To validate the SIMPLICITY will be scored from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD8+ (<0.200x103/MicroL at month 1)

    Measured: At 1 month from transplant

  2. To validate SIMPLICITY Score to characterize the immunological situation of the RT recipient at six months of transplantation.

    To validate the SIMPLICITY will be scored from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD3+ (<0.500x103 MicroL at 6 months).

    Measured: At 6 months from transplant

Secondary outcomes (27)
  1. Correlation of IgG and infectious complications

    Correlation of IgG and the incidence of infectious complications increased.

    Measured: Up to 12 moths from transplant

  2. Correlation of C3 and infectious complications

    Correlation of C3 and the incidence of infectious complications increased.

    Measured: Up to 12 moths from transplant

  3. Correlation of count lymphocyte T CD3+ in Peripheral blood and infectious complications

    Correlation count of lymphocyte subpopulations CD3+ and the incidence of infectious complications increased.

    Measured: Up to 12 moths from transplant

  4. Correlation of count lymphocyte T CD8+ in Peripheral blood and infectious complications

    Correlation count of lymphocyte subpopulations CD8+ and the incidence of infectious complications increased.

    Measured: Up to 12 moths from transplant

  5. Acute rejection with histologic confirmation by conventional criteria

    Number of patients who have had at least one acute biopsy-proven rejection throughout the study.

    Measured: Up to 12 moths from transplant

  6. Graft loss with or without retransplantation.

    Number of patients who have lost the graft throughout the study.

    Measured: Up to 12 moths from transplant

  7. Mortality infectious cause

    Number of dead patients and whose cause of death is Infection.

    Measured: Up to 12 moths from transplant

  8. Mortality otherwise.

    Number of dead patients whose cause of death has indicated a different cause to Infection (ie the reason for death was due to ischemic heart disease, or by another cardiovascular complication, or by neoplastic disease or by others).

    Measured: Up to 12 moths from transplant

  9. CMV infection/Disease

    Percentage of patients presenting at least one CMV disease throughout the study, from the transplant and number of CMV diseases per patient.

    Measured: Up to 12 moths from transplant

  10. CMV viremia

    Number of patients who had CMV positive viremia (either PCR (Polymerase Chain Reaction) or antigenemia) at least during one visit (No. of copies>0 IU/mL in PCR or>100,000/cell in Antigenemia).

    Measured: Up to 12 moths from transplant

  11. To analyze the influence of low lymphocyte count in the increase of the rate of major infectious complications.

    Low lymphocyte count, defined as lymphocytes <1500 cells/mcl and the rate of major infectious complications

    Measured: Up to 12 moths from transplant

  12. To analyze the influence of CMV serology in the increase of the rate of major infectious complications.

    CMV receptor serology vs. donor CMV Serology (ie, a new categorical variable will be constructed combining donor and recipient serology: D+/R+, D-/R +,D-/R-, D+/R-) and the rate of major infectious complications

    Measured: Up to 12 moths from transplant

  13. To analyze the influence of Historical PRA (Panel Reactive Antibody) in the increase of the rate of major infectious complications

    Historical PRA (%) and the rate of major infectious complications

    Measured: Up to 12 moths from transplant

  14. To analyze whether viremia has any impact on the occurrence of other opportunistic diseases

    Presence of major post-transplant infectious complication and the occurrence of other opportunistic diseases.

    Measured: Up to 12 moths from transplant

  15. To analyze whether CMV disease has any impact on the occurrence of other opportunistic diseases.

    Presence of CMV disease and the occurrence of other opportunistic diseases.

    Measured: Up to 12 moths from transplant

  16. To analyze the role of Anticipated treatment and the influence in the appearance of infection or disease by CMV.

    Indication of Anticipated treatment and appearance of infection or disease by CMV.

    Measured: Up to 12 moths from transplant

  17. To analyze the role of Antiviral prophylaxis and the influence in the appearance of infection or disease by CMV.

    Indication of Antiviral prophylaxis appearance of infection or disease by CMV.

    Measured: Up to 12 moths from transplant

  18. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 1 month of transplantation on overall survival throughout the first year of evolution.

    SIMPLICITY Score at 1 month of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD8+ (<0.200x103/MicroL at month 1)) and overall survival throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  19. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 1 month of transplantation on graft survival throughout the first year of evolution.

    SIMPLICITY Score at 1 month of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD8+ (<0.200x103/MicroL at month 1)) and graft survival throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  20. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 1 month of transplantation on the incidence of acute rejection throughout the first year of evolution.

    SIMPLICITY Score at 1 month of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD8+ (<0.200x103/MicroL at month 1)) and the incidence of acute rejection throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  21. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 1 month of transplantation on vascular disease throughout the first year of evolution.

    SIMPLICITY Score at 1 month of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD8+ (<0.200x103/MicroL at month 1)) and vascular disease throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  22. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 1 month of transplantation on diabetes throughout the first year of evolution throughout the first year of evolution.

    SIMPLICITY Score at 1 month of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD8+ (<0.200x103/MicroL at month 1)) and diabetes throughout the first year of evolution throughout the first.

    Measured: Up to 12 moths from transplant

  23. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 6 months of transplantation on overall survival throughout the first year of evolution.

    SIMPLICITY Score at 6 months of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD3+ (<0.500x103 MicroL at 6 months)) and overall survival throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  24. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 6 months of transplantation on graft survival throughout the first year of evolution.

    SIMPLICITY Score at 6 months of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD3+ (<0.500x103 MicroL at 6 months)) and graft survival throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  25. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 6 months of transplantation on the incidence of acute rejection throughout the first year of evolution.

    SIMPLICITY Score at 6 months of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD3+ (<0.500x103 MicroL at 6 months)) and the incidence of acute rejection throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  26. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 6 months of transplantation on vascular disease throughout the first year of evolution.

    SIMPLICITY Score at 6 months of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD3+ (<0.500x103 MicroL at 6 months)) and vascular disease throughout the first year of evolution.

    Measured: Up to 12 moths from transplant

  27. To analyze the influence of the renal transplant recipient's SIMPLICITY Score at 6 months of transplantation on diabetes throughout the first year of evolution throughout the first year of evolution.

    SIMPLICITY Score at 6 months of transplantation (from 0 to 3, assigning one point to each of the following parameters: IgG hypogammaglobulinemia (<700 mg/ dL) , C3 hypocomplementemia (<83 mg/dL) and low counts in Peripheral blood of lymphocyte T CD3+ (<0.500x103 MicroL at 6 months)) and diabetes throughout the first year of evolution throughout the first.

    Measured: Up to 12 moths from transplant

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Mar 2017
  2. Study startAug 2014
  3. Primary completion15 Feb 2017
  4. Study completion15 Feb 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
577 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03083756
Sponsor's protocol ID
SET-INF-2014-01
Acronym
SIMPLICITY
Status last verified
Mar 2017
First submitted
8 Mar 2017
Last updated
20 Mar 2017
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Opportunistic Infections, run by Sociedad Española de Trasplante at 15 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To validate SIMPLICITY Score to characterize the immunological situation of the RT recipient at month of transplantation). (time frame: At 1 month from transplant). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Mar 2017.

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