Peripheral and Intrarenal B Cell Study in Antibody Mediated Transplant Rejection : Phenotypic and Transcriptional Study, Study of Reactivity

Condition(s) studied

Investigational drug(s) / intervention(s)

Piece of kidney removal: removal for a piece of kidney for research purposes during biopsy or graft removal performed as part of routine care

Stool collection: Stool collection for research purposes

Blood collection: Additional blood volume for research purposes during a routine blood collection

Study summary

Humoral rejection of kidney transplants is responsible for a large number of kidney graft losses in a context of increasing shortage.

Although it has been established that it is largely mediated by the alloreactive B lymphocyte, anti-B therapies are only partially effective.

The mechanisms behind the loss of tolerance are also poorly understood, and the triggers of rejection remain to be elucidated.

During this study, patients admitted for kidney graft biopsy for suspicion of rejection will be included ; patients presenting non inflammatory biopsies will be studied as controls. B cells will be extracted and cultured. Their antibodies will be studied along with reactivity towards HLA, non HLA targets and the gut microbiome. The same study will be led for late rejections needing graft removal : B cells extraction, culture, antibodies reactivity testing. Controls will be graft removal for non inflammatory causes. In both cases hight throughput sequencing the immunoglobulin genes will be performed.

Eligibility

Primary outcome measure(s)

• Characterization of lymphocytes in humoral rejection — Day 1
  Using Flow cytometry analysis

Trial sites (2)

More Assistance Publique - Hôpitaux de Paris trials in France