Allosure in Simultaneous Pancreas Kidney Transplant

Study Overview
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Brief Summary
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This study will observe donor derived cell free DNA percentages (via the Allosure test) in combined kidney-pancreas transplant recipients to establish both stable and dysfunctional Allosure assay levels

Detailed Description
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Simultaneous kidney-pancreas transplantation is the optimal treatment for select patients with type 1 diabetes and kidney failure. Limited biomarkers are utilized to monitor the health of the allografts. For kidney transplantation serum creatinine remains the most commonly monitored biomarker; for the pancreas allograft blood glucose and serum amylase and lipase are measured. However, these biomarkers are imprecise and non-specific for rejection. In kidney transplantation cell free donor derived DNA at of value of >1% has emerged as an effective immune monitoring tool as a marker for renal allograft rejection and injury. Thus far, a discriminatory donor derived cell free DNA value for a stable and rejecting allografts has not been established for recipients of combined kidney-pancreas transplants. Study aim will be to help establish a normal range of donor derived cell free DNA in stable kidney-pancreas graft function in combined kidney pancreas transplant recipients while determining changes in cell free DNA in kidney-pancreas recipients with biopsy proven allograft rejection.

Official Title
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Assessment of Donor Derived Cell-free DNA in Combined Kidney-pancreas Recipients

Conditions
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Kidney Pancreas Transplant

Intervention / Treatment
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* Other: DD-cfDNA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 years Kidney-pancreas transplant recipients Patient must have stable creatine, lipase, amylase for at least a two month span after transplant OR patient must receive a biopsy within one year post transplant Exclusion Criteria: Presence of non-renal or pancreas transplanted organ Patient is not enrolled within 1 year after transplant

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| WU/Barnes cohort<br>SPK patients in this group will be recruited from WU/Barnes Transplant center. A total of 25 from this cohort will be recruited and asked to provide a blood sample to test for donor derived cell free DNA 3 times over the course of the first year of transplant. In addition, if any biopsies or rejections occur, additional samples will be requested at the time of biopsy and for an additional two follow-ups at least one month apart. | Other: DD-cfDNA<br>* We are obtaining samples for donor derived cell free DNA in an observational manner. There is no intervention in this study<br>|
| UT Southwestern cohort<br>SPK patients in this group will be recruited from WU/Barnes Transplant center. A total of 25 from this cohort will be recruited and asked to provide a blood sample to test for donor derived cell free DNA 3 times over the course of the first year of transplant. In addition, if any biopsies or rejections occur, additional samples will be requested at the time of biopsy and for an additional two follow-ups at least one month apart. | Other: DD-cfDNA<br>* We are obtaining samples for donor derived cell free DNA in an observational manner. There is no intervention in this study<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| DD-cfDNA level | determine level of donor derived cell free DNA from SPK patients | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Kidney pancreas transplant, Deceased donor cell free DNA