HLA-specific Antibody Monitoring Post Renal Transplant

  • Research type

    Research Study

  • Full title

    Expanding the scope of post-transplant HLA-specific antibody detection and monitoring in renal transplant recipients

  • IRAS ID

    322001

  • Contact name

    Petra Goldsmith

  • Contact email

    petra.goldsmith@liverpoolft.nhs.uk

  • Sponsor organisation

    Liverpool University Hospitals NHS Foundation Trust

  • Clinicaltrials.gov Identifier

    322001, IRAS

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    A kidney transplant is performed to replace the function of a patient's kidneys when they have failed. A transplant will almost always be from a genetically distinct organ donor which means the recipient will need to take immunosuppressant drugs which reduces the chance of their immune system recognising the kidney as foreign and attacking it. Nonetheless, rejection can occur when the recipient's immune system causes damage to the transplant, one way of which is by developing antibodies against the transplant. Rejection due to antibodies is particularly difficult to identify and treat so any testing that enables early detection before there is evidence of kidney injury is beneficial.

    Immunosuppressants, particularly those used in the treatment of rejection can have serious side effects such as cancer and infection. Older transplant recipients are particularly at risk as their immune systems are not so able to withstand the effects. Additionally, they are less likely to get rejection episodes and could benefit from overall reductions to their immunosuppression burden.

    Methods of post-transplant antibody detection are somewhat limited and it can be difficult to determine what is a new antibody and what clinical impact it can have. Changes in antibody reactivity over time are important but we have no facility for routinely examining patients after transplant for antibodies against the kidney.

    Our research, therefore has three key aims: i) to try out a new DNA test which can be an early marker for antibody formation; ii) to test all patients having a transplant for post-transplant antibodies and to compare older age patients (≥60 versus <60) to see if age truly does have a protective effect on antibody formation; iii) to examine a subset of these patients over 12 months post-transplant to determine the occurrence of new antibody, and thus the value of routine post-transplant testing.

  • REC name

    Wales REC 3

  • REC reference

    23/WA/0260

  • Date of REC Opinion

    20 Sep 2023

  • REC opinion

    Favourable Opinion