NCT04804891 · Columbia University
Using T-Cell Alloreactivity and Chimerism to Guide Immunosuppression Minimization in Intestinal Transplantation
What this study is about
The purpose of this study is to investigate the safety and feasibility of giving intestinal transplant patients CD34+ stem cells (the cells that make all the types of blood cells) obtained from their organ donor's bone marrow.
View original scientific description
The purpose of this study is to investigate the safety and feasibility of giving intestinal transplant patients CD34+ stem cells (the cells that make all the types of blood cells) obtained from their organ donor's bone marrow. The goal of this is to develop a post-transplant treatment strategy that controls rejection while reducing the high risk of infection and malignant disease associated with the high levels of immunosuppression medication(s) that intestinal and multi-organ transplant patients must take. Infusion of bone marrow cells from the same donor of the transplanted organ(s) could promote a state called "mixed chimerism" in which both donor cells and recipient cells coexist in the body with the ultimate goal of minimizing the amount of immunosuppression medication(s) needed.
Interventions
BIOLOGICAL
Cell Therapy
Infusion of containing 1x106/kg CD34+ cells from donor bone marrow selected using the CliniMACS® CD34 Reagent System.
Primary outcome measures
Total number of participants with moderate to severe GVHD
Time frame: Up to 4 years after transplantation
Total number of participants with moderate to severe (at least Grade II) graft-versus-host disease (GVHD) will be monitored.
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- All patients actively listed as candidates for intestinal or multi-visceral transplant at the study site; while all patients who are actively listed in United Network for Organ Sharing (UNOS) for intestinal and/or multi-visceral transplantation, including those who have previously received a multi-visceral transplant and are re-listed, are eligible for participation, the following are examples of listing criteria suitable for enrollment in this clinical trial:
- Short Bowel Syndrome (SBS) due to:
- Trauma (multiple resections/explorations and/or vascular abdominal trauma superior mesenteric artery (SMA) / superior mesenteric vein (SMV) injuries)
- Gastroschisis
- Necrotizing Enterocolitis
- Intestinal Atresia
- Crohn's Disease
- Hirschprung's Disease
- Chronic Intestinal Pseudo-Obstruction
- Malabsorption:
- Microvillus Inclusion Disease
- Tufting Enteropathy
- Complete portomesenteric thrombosis with cirrhosis
- Slow-growing, low-malignancy potential tumors infiltrating mesenteric root:
- Gardner's Syndrome
- Familial Adenomatous Polyposis
- Desmoid Tumor with Intra-Abdominal Infiltration
- Endocrine Tumors
- Re-transplant candidates who lost the first graft to rejection or patients who have higher risk of toxicity from chronic long term immunosuppression (i.e., patients with chronic kidney disease)
- Patient commits to planned follow up at a study site for the 48-month duration of study procedures
- Age ≥18 years old and ≤65 years old
- Subjects or capable of signing the informed consent document themselves
Exclusion criteria
- Active systemic infection with hemodynamic instability and/or sepsis
- Patients with known immunodeficiency syndrome
- Carcinoma with metastasis (except neuro-endocrine tumors, even in the presence of metastasis these patients may undergo multivisceral/cluster transplantation)
- Severe cardiovascular and/or respiratory instability, as defined by requirement of pressors or ventilator
- Severe cerebral edema, with radiologic findings of effaced sulci and/or herniation
- Poorly controlled hypertension (systolic blood pressure \> 170 on at least 2 occasions), diabetes mellitus (HbA1c \> 8), or uncontrollable seizure disorders
- Age \> 65 years
- Documented history of non-compliance with medical therapy and follow-up
- Substance addiction in the last six months
- Psychosocial Instability: absence of a consistent reliable social support system
- Significant or active psychiatric disorder associated with the inability to cooperate or comply with medical therapy
- In the judgement of the clinical team, severely limited functional status with poor rehabilitation potential
- Multi-organ failure and preceding CD34+ infusion
- Pre formed panel reactive antibodies (PRA) mean fluorescein intensity (MFI) \> 5000 by Luminex
- Patients who are pregnant or breast-feeding or intend to get pregnant during the study period
- Patients who have developed moderate or severe rejection before post-transplant day 11
- Vulnerable populations, such as incarcerated or institutionalized individuals
- Subjects with clinical features suggestive of GVHD
- Subjects who are hemodynamically unstable (i.e., requiring vasopressor support)
- Female subjects of childbearing age and male patients who are not using and/or unwilling to use an effective method of birth control for the duration of the trial activities
- History of previous hematopoietic progenitor cell (HPC) infusion or transplant of any kind. Note: Human leukocyte antigen (HLA) mismatch will not be one of the exclusion criteria
Where
- New York, New York
Collaborators
Ossium Health, Inc.
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Apr 1, 2026 · Source of record for eligibility and locations