Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| CNV0042139 | Other Grant/Funding Number | Roche Laboratories, Inc. |
Not provided
Not provided
Study stopped due to lack of efficacy & funding.
Not provided
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| Name | Class |
|---|---|
| Roche Pharma AG | INDUSTRY |
Not provided
Not provided
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This is an open label, single-center, randomized phase IV pilot study of steroid and calcineurin inhibitor avoidance in renal transplant recipients. All patients will receive two doses of alemtuzumab to achieve peripheral T-cell depletion. Intravenous glucocorticoids will be administered prior to alemtuzumab administration to limit cytokine release syndrome in association with this monoclonal antibody, and continued for the first two days post-transplant. Thereafter, steroids will not be used for immunosuppression. All transplant recipients will be started on oral immunosuppressive therapy with mycophenolate mofetil (MMF) prior to transplant. Pretransplant, these patients will be randomized to receive, in addition, either tacrolimus (Tac) or sirolimus.
After six months, patients in the tacrolimus arm who do not experience rejection will be randomized to continue on tacrolimus or to be converted to the combination of sirolimus and MMF. Individuals in this arm of the study who do not experience acute rejection, and demonstrate evidence of donor specific hyporesponsiveness at 9 months post-transplant (those staying on Tac + MMF) or 3 months post-conversion (those converted from Tac + MMF to sirolimus + MMF) will be weaned to MMF monotherapy.
Individuals in the sirolimus + MMF arm who do not experience acute rejection and demonstrate evidence of donor specific hyporesponsiveness at 6 months post-transplant will be weaned to MMF monotherapy.
Not provided
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1: Alemtuzumab + TAC + MMF | Active Comparator | Receive two doses of alemtuzumab (Campath-1H, 30mg) by intravenous (IV) infusion. One dose during kidney transplant surgery and the second dose on day 2 (post-surgery) to achieve peripheral T-cell depletion. IV glucocorticoids will be given prior to Campath administration to limit cytokine release syndrome in association with this monoclonal antibody. MMF on the day of surgery and continue taking it by mouth, twice daily. TAC started on the 1st day after surgery, and then taken by mouth twice daily. |
|
| Group 2: Alemtuzumab + Sirolimus + MMF | Active Comparator | Sirolimus will be taken by mouth before transplant surgery and will continue taking once daily after surgery. Group 2 will also receive 2 doses of Alemtuzumab: one during surgery and the second will be given on the second day after surgery. Mycophenolate mofetil will be give on the day of surgery and twice daily, by mouth, as instructed by the doctor. If subjects do not experience kidney rejection after 6 months after surgery, they will be weaned off of the sirolimus and continue taking the mycophenolate mofetil. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tacrolimus (TAC) | Drug | Tacrolimus (TAC) will be given standard of care by prescription twice a day (2.0 mg), orally. Doses will be adjusted by serum levels. The dose will be modified to achieve 12 hour trough concentrations of 5-8 ng/mL. |
| Measure | Description | Time Frame |
|---|---|---|
| The Incidence of Biopsy-proven Acute Allograft Rejection During the First 12 Months of Transplant. | The incidence of rejection is determined by the proportion of patients experiencing biopsy proven acute allograft rejection during the first 12 months post-transplant. | Within 12 months post kidney transplant |
| Measure | Description | Time Frame |
|---|---|---|
| Severity of Acute Rejection During the First 6 and 12 Months Post-transplant | The diagnosis of rejection will be based on clinical symptoms and signs, laboratory tests, and confirmed by core renal allograft biopsy. | Months 6-12 post-transplant |
| Renal Function at 12 Months Post-transplant |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Known sensitivity or contraindication to sirolimus, tacrolimus or MMF
Patient with significant or active infection
Patients with a positive lymphocytotoxic crossmatch using donor lymphocytes and recipient serum
Patients with PRA > 20%
Patients who are pregnant or nursing mothers
Patients whose life expectancy is severely limited by diseases other than renal disease
Ongoing active substance abuse, drug or alcohol
Major ongoing psychiatric illness or recent history of noncompliance
Significant cardiovascular disease (e.g.):
Malignancy within 3 years, excluding non-melanoma skin cancers
Serologic evidence of infection with HIV or HBVsAg positive
Patients with a screening/baseline total white blood cell count < 4,000/mm3; platelet count < 100,000/mm3; triglycerides > 400 mg/dl; total cholesterol > 300 mg/dl
Investigational drug within 30 days prior to transplant surgery
Anti-T cell therapy within 30 days prior to transplant surgery
Patients using Prednisone
Patients who are ABO incompatible
Not provided
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| Name | Affiliation | Role |
|---|---|---|
| Joseph R Leventhal, MD, PhD | Northwestern University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Northwestern University/Northwestern Memorial Hospital | Chicago | Illinois | 60611 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 3275896 | Background | Eggers PW. Effect of transplantation on the Medicare end-stage renal disease program. N Engl J Med. 1988 Jan 28;318(4):223-9. doi: 10.1056/NEJM198801283180406. | |
| 10699159 | Background | Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ, Stablein D. Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med. 2000 Mar 2;342(9):605-12. doi: 10.1056/NEJM200003023420901. |
Not provided
Not provided
Before being randomized (assigned to group) into Group 1 or Group 2, patients were screened based on inclusion/exclusion criteria (see Eligibility Criteria section). Randomization was decided before transplant surgery. Before re-randomization could begin (6 months after surgery), subjects could not be showing signs of organ rejection.
All patients were approached in the transplant clinic a Northwestern Memorial Hospital. Recruitment began April 2005 and ended April 2009.
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Group 1: Alemtuzumab + TAC (Prograf) + MMF | Receive two doses of alemtuzumab (Campath-1H, 30mg) by intravenous (IV) infusion. One dose during kidney transplant surgery and the second dose on day 2 (post-surgery) to achieve peripheral T-cell depletion. IV glucocorticoids will be given prior to Campath administration to limit cytokine release syndrome in association with this monoclonal antibody. MMF on the day of surgery and continue taking it by mouth, twice daily. TAC started on the 1st day after surgery, and then taken by mouth twice daily. |
| FG001 | Group 2: Alemtuzumab + Sirolimus + MMF | Sirolimus will be taken by mouth before transplant surgery and will continue taking once daily after surgery. Group 2 will also receive 2 doses of Alemtuzumab: one during surgery and the second will be given on the second day after surgery. Mycophenolate mofetil will be give on the day of surgery and twice daily, by mouth, as instructed by the doctor. If subjects do not experience kidney rejection after 6 months after surgery, they will be weaned off of the sirolimus and continue taking the mycophenolate mofetil. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Group 1: Alemtuzumab + TAC (Prograf) + MMF | Receive two doses of alemtuzumab (Campath-1H, 30mg) by intravenous (IV) infusion. One dose during kidney transplant surgery and the second dose on day 2 (post-surgery) to achieve peripheral T-cell depletion. IV glucocorticoids will be given prior to Campath administration to limit cytokine release syndrome in association with this monoclonal antibody. MMF on the day of surgery and continue taking it by mouth, twice daily. TAC (Prograf) started on the 1st day after surgery, and then taken by mouth twice daily. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | The Incidence of Biopsy-proven Acute Allograft Rejection During the First 12 Months of Transplant. | The incidence of rejection is determined by the proportion of patients experiencing biopsy proven acute allograft rejection during the first 12 months post-transplant. | 33 total subjects reached the 12 month participation mark. | Posted | Number | Participants | Within 12 months post kidney transplant |
|
Not provided
Not provided
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Group 1: Alemtuzumab + TAC + MMF | Receive two doses of alemtuzumab (Campath-1H, 30mg) by intravenous (IV) infusion. One dose during kidney transplant surgery and the second dose on day 2 (post-surgery) to achieve peripheral T-cell depletion. IV glucocorticoids will be given prior to Campath administration to limit cytokine release syndrome in association with this monoclonal antibody. MMF on the day of surgery and continue taking it by mouth, twice daily. TAC started on the 1st day after surgery, and then taken by mouth twice daily. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Deep vein thrombosis | Blood and lymphatic system disorders |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Chest Pain | Musculoskeletal and connective tissue disorders |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Joseph Leventhal, MD, PhD, Associate Professor | Comprehensive Transplant Center, Northwestern University | (312) 695-1703 | jleventh@nmh.org |
Not provided
| ID | Term |
|---|---|
| D012059 | Rejection, Psychology |
| ID | Term |
|---|---|
| D012919 | Social Behavior |
| D001519 | Behavior |
Not provided
Not provided
| ID | Term |
|---|---|
| D016559 | Tacrolimus |
| D020123 | Sirolimus |
| D000074323 | Alemtuzumab |
| D009173 | Mycophenolic Acid |
| ID | Term |
|---|---|
| D018942 | Macrolides |
| D007783 | Lactones |
| D009930 | Organic Chemicals |
| D061067 | Antibodies, Monoclonal, Humanized |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| Sirolimus | Drug | Sirolimus will be given standard of care by prescription, dosed at 5mg daily. The dosage will be adjusted by serum level to achieve 24 hour trough concentrations of 8-12 ng/mL by HPLC assay. |
|
|
| Alemtuzumab | Drug | Patients receiving alemtuzumab will be premedicated with 50mg of diphenhydramine hydrochloride, and 650mg of acetaminophen 30-60 minutes to the first Alemtuzumab infusion. The of 30mg will be diluted in 100cc sterile 0.9% normal saline and infused over 2 hours. The infusion line must contain an in-line 0.22-micron filter. Alemtuzumab will be administered on the day of transplant (intraoperatively), and on post-operative day 2. Both doses will be administered while the patient is in the hospital. Alemtuzumab is supplied in single-use clear glass ampoules containing 30mg of alemtuzumab in 3mL of solution. |
|
|
| Mycophenolate mofetil (MMF) | Drug | MMF will be given at 1.0-1.5gm, twice daily, orally. The first dose will be given pre-transplant, open label fashion. |
|
|
Laboratory tests for renal function include creatinine or iothalamate glomerular filtration rate (GFR). |
| At 12 months post-transplant |
| Incidence of Donor Specific Hyporesponsiveness Allowing for the Conversion to Monotherapy | The proportion of subjects for both groups determine this measure: 1) Patients in tacrolimus arm who do not experience acute rejection and demonstrate evidence of donor specific hyporesonsiveness at 9 months post-transplant (those staying on TAC+MMF) or 3 months post-convertion (converted from TAC+MMF to Sirolimus+MMF) will be weaned to MMF monotherapy; 2) Those in the sirolimus+MMF arm who do not experience acute rejection and demonstrate evidence of donor specific hyporesponsiveness at 6 months post-transplant will be weaned to MMF monotherapy. | At 6 & 9 months post-transplant |
| Patient and Graft Survival Rates at 6 and 12 Months Post-transplant | At 6 & 12 months post-transplant |
| 1281071 | Background | Barry JM. Immunosuppressive drugs in renal transplantation. A review of the regimens. Drugs. 1992 Oct;44(4):554-66. doi: 10.2165/00003495-199244040-00003. |
| 7832839 | Background | Suthanthiran M, Strom TB. Renal transplantation. N Engl J Med. 1994 Aug 11;331(6):365-76. doi: 10.1056/NEJM199408113310606. No abstract available. |
| 8193291 | Background | Helderman JH, Van Buren DH, Amend WJ Jr, Pirsch JD. Chronic immunosuppression of the renal transplant patient. J Am Soc Nephrol. 1994 Feb;4(8 Suppl):S2-9. doi: 10.1681/ASN.V48s2. |
| 11729003 | Background | Gaston RS. Maintenance immunosuppression in the renal transplant recipient: an overview. Am J Kidney Dis. 2001 Dec;38(6 Suppl 6):S25-35. doi: 10.1053/ajkd.2001.28923. |
| 1498281 | Background | Pirsch JD, D'Alessandro AM, Sollinger HW, Knechtle SJ, Reed A, Kalayoglu M, Belzer FO. Hyperlipidemia and transplantation: etiologic factors and therapy. J Am Soc Nephrol. 1992 Jun;2(12 Suppl):S238-42. doi: 10.1681/ASN.V212s238. |
| 8697605 | Background | Shaw LM, Kaplan B, Kaufman D. Toxic effects of immunosuppressive drugs: mechanisms and strategies for controlling them. Clin Chem. 1996 Aug;42(8 Pt 2):1316-21. |
| 9238621 | Background | Boubenider S, Hiesse C, Goupy C, Kriaa F, Marchand S, Charpentier B. Incidence and consequences of post-transplantation lymphoproliferative disorders. J Nephrol. 1997 May-Jun;10(3):136-45. |
| 9624195 | Background | Fishman JA, Rubin RH. Infection in organ-transplant recipients. N Engl J Med. 1998 Jun 11;338(24):1741-51. doi: 10.1056/NEJM199806113382407. No abstract available. |
| 9728599 | Background | DeMario MD, Liebowitz DN. Lymphomas in the immunocompromised patient. Semin Oncol. 1998 Aug;25(4):492-502. |
| 9531938 | Background | Sia IG, Paya CV. Infectious complications following renal transplantation. Surg Clin North Am. 1998 Feb;78(1):95-112. doi: 10.1016/s0039-6109(05)70637-x. |
| 9112351 | Background | Pirsch JD, Miller J, Deierhoi MH, Vincenti F, Filo RS. A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group. Transplantation. 1997 Apr 15;63(7):977-83. doi: 10.1097/00007890-199704150-00013. |
| 10628766 | Background | Ahsan N, Hricik D, Matas A, Rose S, Tomlanovich S, Wilkinson A, Ewell M, McIntosh M, Stablein D, Hodge E. Prednisone withdrawal in kidney transplant recipients on cyclosporine and mycophenolate mofetil--a prospective randomized study. Steroid Withdrawal Study Group. Transplantation. 1999 Dec 27;68(12):1865-74. doi: 10.1097/00007890-199912270-00009. |
| 11397963 | Background | Vincenti F, Ramos E, Brattstrom C, Cho S, Ekberg H, Grinyo J, Johnson R, Kuypers D, Stuart F, Khanna A, Navarro M, Nashan B. Multicenter trial exploring calcineurin inhibitors avoidance in renal transplantation. Transplantation. 2001 May 15;71(9):1282-7. doi: 10.1097/00007890-200105150-00017. |
| 7680544 | Background | Randhawa PS, Shapiro R, Jordan ML, Starzl TE, Demetris AJ. The histopathological changes associated with allograft rejection and drug toxicity in renal transplant recipients maintained on FK506. Clinical significance and comparison with cyclosporine. Am J Surg Pathol. 1993 Jan;17(1):60-8. doi: 10.1097/00000478-199301000-00007. |
| 9825819 | Background | Birkeland SA. Steroid-free immunosuppression after kidney transplantation with antithymocyte globulin induction and cyclosporine and mycophenolate mofetil maintenance therapy. Transplantation. 1998 Nov 15;66(9):1207-10. doi: 10.1097/00007890-199811150-00016. |
| 9734890 | Background | Calne R, Friend P, Moffatt S, Bradley A, Hale G, Firth J, Bradley J, Smith K, Waldmann H. Prope tolerance, perioperative campath 1H, and low-dose cyclosporin monotherapy in renal allograft recipients. Lancet. 1998 Jun 6;351(9117):1701-2. doi: 10.1016/S0140-6736(05)77739-4. No abstract available. |
| Background | Calne RY. Initial Experience with Campath-1H in Renal Transplantation. Transplantation Reviews 2003, in press. |
| 12780564 | Background | Knechtle SJ, Pirsch JD, H Fechner J Jr, Becker BN, Friedl A, Colvin RB, Lebeck LK, Chin LT, Becker YT, Odorico JS, D'Alessandro AM, Kalayoglu M, Hamawy MM, Hu H, Bloom DD, Sollinger HW. Campath-1H induction plus rapamycin monotherapy for renal transplantation: results of a pilot study. Am J Transplant. 2003 Jun;3(6):722-30. doi: 10.1034/j.1600-6143.2003.00120.x. |
| 12865797 | Background | Kirk AD, Hale DA, Mannon RB, Kleiner DE, Hoffmann SC, Kampen RL, Cendales LK, Tadaki DK, Harlan DM, Swanson SJ. Results from a human renal allograft tolerance trial evaluating the humanized CD52-specific monoclonal antibody alemtuzumab (CAMPATH-1H). Transplantation. 2003 Jul 15;76(1):120-9. doi: 10.1097/01.TP.0000071362.99021.D9. |
| 12814480 | Background | Hricik DE, Rodriguez V, Riley J, Bryan K, Tary-Lehmann M, Greenspan N, Dejelo C, Schulak JA, Heeger PS. Enzyme linked immunosorbent spot (ELISPOT) assay for interferon-gamma independently predicts renal function in kidney transplant recipients. Am J Transplant. 2003 Jul;3(7):878-84. doi: 10.1034/j.1600-6143.2003.00132.x. |
| 12392292 | Background | Gebauer BS, Hricik DE, Atallah A, Bryan K, Riley J, Tary-Lehmann M, Greenspan NS, Dejelo C, Boehm BO, Hering BJ, Heeger PS. Evolution of the enzyme-linked immunosorbent spot assay for post-transplant alloreactivity as a potentially useful immune monitoring tool. Am J Transplant. 2002 Oct;2(9):857-66. doi: 10.1034/j.1600-6143.2002.20908.x. |
| 12135422 | Background | Reinsmoen NL. Cellular methods used to evaluate the immune response in transplantation. Tissue Antigens. 2002 Apr;59(4):241-50. doi: 10.1034/j.1399-0039.2002.590401.x. |
| Withdrawal by Subject |
|
| Physician Decision |
|
| BG001 | Group 2: Alemtuzumab + Sirolimus + MMF | Sirolimus will be taken by mouth before transplant surgery and will continue taking once daily after surgery. Group 2 will also receive 2 doses of Alemtuzumab: one during surgery and the second will be given on the second day after surgery. Mycophenolate mofetil will be give on the day of surgery and twice daily, by mouth, as instructed by the doctor. If subjects do not experience kidney rejection after 6 months after surgery, they will be weaned off of the sirolimus and continue taking the mycophenolate mofetil. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Secondary | Severity of Acute Rejection During the First 6 and 12 Months Post-transplant | The diagnosis of rejection will be based on clinical symptoms and signs, laboratory tests, and confirmed by core renal allograft biopsy. | Study was terminated due to efficacy and there is no data was collected for this outcome measure. | Posted | Months 6-12 post-transplant |
|
|
| Secondary | Renal Function at 12 Months Post-transplant | Laboratory tests for renal function include creatinine or iothalamate glomerular filtration rate (GFR). | Study was stopped due to efficacy and no data was collected for this outcome measure. | Posted | At 12 months post-transplant |
|
|
| Secondary | Incidence of Donor Specific Hyporesponsiveness Allowing for the Conversion to Monotherapy | The proportion of subjects for both groups determine this measure: 1) Patients in tacrolimus arm who do not experience acute rejection and demonstrate evidence of donor specific hyporesonsiveness at 9 months post-transplant (those staying on TAC+MMF) or 3 months post-convertion (converted from TAC+MMF to Sirolimus+MMF) will be weaned to MMF monotherapy; 2) Those in the sirolimus+MMF arm who do not experience acute rejection and demonstrate evidence of donor specific hyporesponsiveness at 6 months post-transplant will be weaned to MMF monotherapy. | Study was stopped due to efficacy and no data was collected for this outcome measure. | Posted | At 6 & 9 months post-transplant |
|
|
| Secondary | Patient and Graft Survival Rates at 6 and 12 Months Post-transplant | Study was stopped due to efficacy and no data was collected for this outcome measure. | Posted | At 6 & 12 months post-transplant |
|
|
| 4 |
| 24 |
| 16 |
| 24 |
| EG001 | Group 2: Alemtuzumab + Sirolimus + MMF | Sirolimus will be taken by mouth before transplant surgery and will continue taking once daily after surgery. Group 2 will also receive 2 doses of Alemtuzumab: one during surgery and the second will be given on the second day after surgery. Mycophenolate mofetil will be give on the day of surgery and twice daily, by mouth, as instructed by the doctor. If subjects do not experience kidney rejection after 6 months after surgery, they will be weaned off of the sirolimus and continue taking the mycophenolate mofetil. | 4 | 16 | 14 | 16 |
| EG002 | Group 1: Post-conversion to Sirolimus | After conversion to Sirolimus, if no rejection of transplanted kidney within 9 months post-transplant, will be weaned off Sirolimus. | 1 | 3 | 2 | 3 |
| Pulmonary emboli | Respiratory, thoracic and mediastinal disorders |
|
| Hypertension/respiratory distress post kidney biospy | Cardiac disorders |
|
| CMV | Infections and infestations |
|
| Abdominal hernia | Skin and subcutaneous tissue disorders |
|
| Would dishiscence | Skin and subcutaneous tissue disorders |
|
| Shortness of breath | Respiratory, thoracic and mediastinal disorders |
|
| Community aquired pneumonia | Respiratory, thoracic and mediastinal disorders |
|
| Anemia | Blood and lymphatic system disorders |
|
| Shingles | Skin and subcutaneous tissue disorders |
|
| Severe cellular rejection | Renal and urinary disorders |
|
| Antibody mediated rejection | Renal and urinary disorders |
|
| Right upper quadrant pain post conversion to rapamune | General disorders |
|
| Orthostatic hypertension | Cardiac disorders |
|
| Diarrhea | Gastrointestinal disorders |
|
| Pyelonephritis | Renal and urinary disorders |
|
| Hyperkalemia | Blood and lymphatic system disorders |
|
| Bladder spasms | Renal and urinary disorders |
|
| Positive sputum culture | Infections and infestations |
|
| Urinary tract infection | Renal and urinary disorders |
|
| Nausea, vomiting, diarrhea | Gastrointestinal disorders |
|
| Cellulitis of AV fistula repair site | Infections and infestations |
|
| Fluid collection around kidney | Renal and urinary disorders |
|
| Abdominal pain | General disorders |
|
| Fever | Infections and infestations |
|
| Acute allograft rejection | Renal and urinary disorders |
|
Not provided
Not provided
| D000911 |
| Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D002208 | Caproates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D005227 | Fatty Acids |
| D008055 | Lipids |