Immunosuppression Reduction in Failed Allograft Guided by cfDNA

Immunosuppression Reduction in Failed Allograft Guided by cfDNA

The optimal timing for immunosuppression tapering for patients with failed kidney transplant is not known. This pilot study would be to correlate rise in cf-DNA and increase in cPRA.

This is an observational cohort study collecting data and blood specimens at designated time points. The primary outcome will be comparing the cPRA in patients that have a rise in cf-DNA to those that do not have a rise in cf-DNA. Seondary outcomes include comparison of the combined incidence of need for transfusion, need for methylprednisolone and allograft nephrectomy, ESA dose, allograft tenderness, and gross hematuria.

Inclusion Criteria:

• Failed allograft requiring dialysis
• No living donor available for re-transplant option or anticipated deceased donor within the next 12 months
• Patient to be enrolled prior to 3rd HD (hemodialysis) session or within 1 week of starting peritoneal dialysis

Exclusion Criteria:

• 17 years or younger
• cPRA at entrance of 100%
• Primary non-function of the allograft
• Multi-organ transplant