Development of a National Incompatible Kidney Transplant Registry
国家不相容肾移植登记处的发展
基本信息
- 批准号:7938695
- 负责人:
- 金额:$ 49.83万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2009
- 资助国家:美国
- 起止时间:2009-09-30 至 2012-07-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdoptedAntibodiesAreaBiopsyBlood typing procedureClinicalClinical ManagementClinical TrialsComputer softwareComputing MethodologiesCountryDataDeath RateDevelopmentDialysis procedureFundingFutureGoalsGrowthHealthcare SystemsHistocompatibility TestingHuman ResourcesImmunogeneticsInstitutionInterviewKidneyKidney FailureKidney TransplantationLifeLife ExpectancyLinkLiving DonorsMentorsMentorshipMethodologyModalityOnline SystemsOutcomePathologyPatientsProceduresProtocols documentationProviderQuality of lifeRadiology SpecialtyRecordsRecruitment ActivityRegistriesRelianceResearchResearch InfrastructureResourcesStructureTechniquesTestingTimeTransplantationUnited StatesWaiting Listsbasecostdata structuredesensitizationdesignexperienceimprovedmathematical modelmeetingsmembernew technologypatient orientedprogramsprospectivetransplant registry
项目摘要
DESCRIPTION (provided by applicant):
Summary This application addresses broad Challenge Area (07) Enhancing Clinical Trials and specific Challenge Topic, 07-DK-103: Support for Registries. Live donor kidney transplantation is the best treatment for kidney failure, doubling life expectancy and significantly improving quality of life. However, it is estimated that 2000-4000 patients every year find a healthy, willing live donor but are relegated to forego the benefits of live donor renal transplantation because they are ABO or HLA incompatible with their donor. Some of these patients might find compatible matches through kidney paired donation, but those with broad HLA sensitization or hard-to-match blood types (over 50% of incompatible pairs) will not find matches through paired donation. Without incompatible kidney transplantation (IKT), the only other option for these patients is to join the 80,000-patient deceased donor waiting list, where waiting times average 5-7 years and death rates on dialysis exceed 10% per year. IKT is an emerging practice in which patients can receive kidney transplants across antibody barriers through the use of various desensitization techniques. Approximately 200 of these transplants are performed annually in the United States, of which approximately one-third are performed by a handful of high-volume centers and two-thirds are scattered across approximately 90 other very low-volume centers. However, two major challenges currently limit future growth in the field of IKT. First, there is a great need to study and validate specific components of the current protocols and develop best practice. This can only be accomplished if sufficient, detailed data from multiple centers can be collected in a prospective fashion; to date, only single-center studies have been available for analysis. Second, because IKT can be hard to implement due to its reliance on new technology in immunogenetics and pathology, there is a great need for mentoring of new provider teams by more experienced centers. This is currently limited by the inability to readily share detailed, integrated, longitudinal clinical, histological, radiographic, and immuogenetics data. In an effort to better understand IKT and mentor new centers building these programs, we propose to develop a National Incompatible Kidney Transplant Registry. We will design this registry based on a systematic set of in-depth interviews with personnel currently involved in this procedure, and then extend currently existing relational patient management software to accommodate the needs of this registry. We will then pilot test the registry on retrospective cases at our center, prospective cases at our center, and prospective cases from a handful of centers around the country. Finally, we will develop a long-term plan for sustainability. For sensitized patients, IKT is often the only viable treatment option, providing a significant (more than 3- fold) survival benefit to these patients when compared to the next-best available option, namely waiting on the deceased donor waiting list for a compatible donor. Expanding this treatment modality will not only save lives, decrease the long waiting list, and save the US healthcare system significant costs, but will also stimulate the expansion of transplant centers, tissue typing labs, and pathology labs nationwide. Although live donor kidney transplantation is the best treatment for kidney failure, thousands of patients each year have a healthy, willing donor but are relegated to forego the benefits of live donor transplantation because they are incompatible with their donor. Incompatible kidney transplantation is an emerging practice in which patients can receive kidney transplants from their incompatible donors, but this field has thus far been limited to single-center experiences where protocols cannot be validated, best practice cannot be developed, and mentorship of new centers by more experienced centers cannot be accomplished. The goal of this project is to create a detailed, integrated, National Incompatible Kidney Transplant Registry that will link clinical, biopsy, radiology, and antibody data from multiple centers throughout the United States in a way that will greatly improve and expand incompatible kidney transplantation.
描述(由申请人提供):
摘要 本申请解决了广泛的挑战领域 (07) 加强临床试验和特定挑战主题 07-DK-103:对注册管理机构的支持。活体肾移植是治疗肾衰竭的最佳方法,可以使预期寿命加倍并显着提高生活质量。然而,据估计,每年有 2000-4000 名患者找到了健康、自愿的活体供体,但由于 ABO 或 HLA 与供体不相容而被降级而放弃活体供体肾移植的益处。其中一些患者可能通过肾脏配对捐赠找到相容匹配,但那些具有广泛 HLA 敏感性或难以匹配血型(超过 50% 的不相容配对)的患者将无法通过配对捐赠找到匹配。如果不进行不相容肾移植(IKT),这些患者唯一的选择就是加入由 80,000 名患者组成的已故捐献者等待名单,等待时间平均为 5-7 年,透析死亡率每年超过 10%。 IKT 是一种新兴的实践,患者可以通过使用各种脱敏技术跨越抗体屏障接受肾移植。美国每年进行大约 200 例此类移植手术,其中大约三分之一是由少数几个高容量中心进行的,三分之二分散在大约 90 个其他低容量中心进行。然而,目前有两大挑战限制了 IKT 领域的未来发展。首先,非常需要研究和验证当前协议的具体组成部分并开发最佳实践。只有能够以前瞻性的方式从多个中心收集足够、详细的数据,才能实现这一目标;迄今为止,只有单中心研究可供分析。其次,由于 IKT 由于依赖免疫遗传学和病理学新技术而难以实施,因此非常需要经验丰富的中心对新的提供者团队进行指导。目前,由于无法轻松共享详细的、综合的、纵向的临床、组织学、放射学和免疫遗传学数据,这一点受到限制。为了更好地了解 IKT 并指导建立这些项目的新中心,我们建议建立一个国家不相容肾移植登记处。我们将根据对当前参与该程序的人员进行的一系列系统性深入访谈来设计该注册表,然后扩展当前现有的关系型患者管理软件以适应该注册表的需求。然后,我们将对我们中心的回顾性病例、我们中心的前瞻性病例以及来自全国少数中心的前瞻性病例进行试点测试。最后,我们将制定可持续发展的长期计划。对于敏感患者,IKT 通常是唯一可行的治疗选择,与次佳可用选择(即在已故捐赠者等待名单上等待相容捐赠者)相比,为这些患者提供显着(超过 3 倍)的生存获益。扩大这种治疗方式不仅可以挽救生命,减少漫长的等待名单,并为美国医疗保健系统节省大量成本,而且还将刺激移植中心、组织分型实验室和病理实验室在全国范围内的扩张。尽管活体肾移植是治疗肾衰竭的最佳方法,但每年有成千上万的患者拥有健康、自愿的供体,但由于与供体不相容而放弃活体供体移植的益处。不相容肾移植是一种新兴实践,患者可以接受不相容供体的肾移植,但迄今为止,该领域仅限于单中心经验,无法验证方案,无法制定最佳实践,也无法对新中心进行指导经验丰富的中心是无法实现的。该项目的目标是创建一个详细的、综合的国家不相容肾移植登记处,该登记处将连接来自美国多个中心的临床、活检、放射学和抗体数据,从而极大地改善和扩大不相容肾移植。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
ROBERT A MONTGOMERY其他文献
ROBERT A MONTGOMERY的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('ROBERT A MONTGOMERY', 18)}}的其他基金
Transplanting Lungs from Uncontrolled Donation after Circulatory Death
循环死亡后不受控制的捐赠进行肺移植
- 批准号:
10661529 - 财政年份:2022
- 资助金额:
$ 49.83万 - 项目类别:
Transplanting Lungs from Uncontrolled Donation after Circulatory Death
循环死亡后不受控制的捐赠进行肺移植
- 批准号:
10417529 - 财政年份:2022
- 资助金额:
$ 49.83万 - 项目类别:
Development of a National Incompatible Kidney Transplant Registry
国家不相容肾移植登记处的发展
- 批准号:
7828833 - 财政年份:2009
- 资助金额:
$ 49.83万 - 项目类别:
ICAM1 gene inactivation protects against ischemic injury
ICAM1 基因失活可预防缺血性损伤
- 批准号:
7049464 - 财政年份:2002
- 资助金额:
$ 49.83万 - 项目类别:
ICAM1 gene inactivation protects against ischemic injury
ICAM1 基因失活可预防缺血性损伤
- 批准号:
6753175 - 财政年份:2002
- 资助金额:
$ 49.83万 - 项目类别:
ICAM1 gene inactivation protects against ischemic injury
ICAM1 基因失活可预防缺血性损伤
- 批准号:
6621478 - 财政年份:2002
- 资助金额:
$ 49.83万 - 项目类别:
ICAM1 gene inactivation protects against ischemic injury
ICAM1 基因失活可预防缺血性损伤
- 批准号:
6434589 - 财政年份:2002
- 资助金额:
$ 49.83万 - 项目类别:
ICAM1 gene inactivation protects against ischemic injury
ICAM1 基因失活可预防缺血性损伤
- 批准号:
6881422 - 财政年份:2002
- 资助金额:
$ 49.83万 - 项目类别:
ICAM1 gene inactivation protects against ischemic injury
ICAM1 基因失活可预防缺血性损伤
- 批准号:
6765319 - 财政年份:2002
- 资助金额:
$ 49.83万 - 项目类别:
CYTOKINE GENE EXPRESSION DURING T-CELL ONTOGENY
T 细胞个体发育过程中的细胞因子基因表达
- 批准号:
3030651 - 财政年份:1992
- 资助金额:
$ 49.83万 - 项目类别:
相似国自然基金
CDK4/6抑制剂通过IFN/JAK/STAT1信号轴增强PD-1抗体抗肝细胞癌疗效的机制研究
- 批准号:82373313
- 批准年份:2023
- 资助金额:48 万元
- 项目类别:面上项目
抗嗜酸性粒细胞过氧化物酶自身抗体通过PKCζ/PAD4介导EETosis加重哮喘炎症机制研究
- 批准号:82300040
- 批准年份:2023
- 资助金额:30 万元
- 项目类别:青年科学基金项目
金黄色葡萄球菌通过促进抗CD4自身抗体产生参与HIV患者免疫重建不良的机制研究
- 批准号:82302539
- 批准年份:2023
- 资助金额:30 万元
- 项目类别:青年科学基金项目
抑制CDC7通过mTOR-TFEB信号轴增强肝癌PD-1抗体治疗作用及机制研究
- 批准号:82303964
- 批准年份:2023
- 资助金额:30 万元
- 项目类别:青年科学基金项目
自身免疫性mGluR8抗体的鉴定及其通过星形胶质细胞-小胶质细胞活化的通路加重神经元损伤的分子机制研究
- 批准号:82371369
- 批准年份:2023
- 资助金额:47 万元
- 项目类别:面上项目
相似海外基金
DRUG DISCOVERY BY DIRECTED EVOLUTION IN MAMMALIAN CELLS
通过哺乳动物细胞定向进化发现药物
- 批准号:
10644749 - 财政年份:2023
- 资助金额:
$ 49.83万 - 项目类别:
Scalable platforms for understudied histone modifications and modifiers
用于未充分研究的组蛋白修饰和修饰剂的可扩展平台
- 批准号:
10567849 - 财政年份:2023
- 资助金额:
$ 49.83万 - 项目类别:
Mechanisms and therapeutic targeting of osteoimmune functions of RANKL in breast cancer
RANKL在乳腺癌中的骨免疫功能的机制和治疗靶点
- 批准号:
10586000 - 财政年份:2023
- 资助金额:
$ 49.83万 - 项目类别:
Small Molecule Probes for Fluorescence-guided Head and Neck Cancer Surgery
用于荧光引导头颈癌手术的小分子探针
- 批准号:
10644519 - 财政年份:2023
- 资助金额:
$ 49.83万 - 项目类别:
A Flexible High-Throughput Immunological Assay to Support Next-Generation Influenza Vaccine Studies
灵活的高通量免疫分析支持下一代流感疫苗研究
- 批准号:
10655239 - 财政年份:2023
- 资助金额:
$ 49.83万 - 项目类别: