eligibility_summary
Eligible: adults 18–65 with CKD on dialysis, highly sensitized (cPRA>97%) on deceased-donor kidney waitlist, priority >3 yrs with no offers, CMV/EBV IgG+, vaccinated (tetanus, flu, pneumococcus, zoster), WOCBP negative test + contraception, consent required. Exclude: active/recent infections (HIV, HBV/HCV, TB), immunodeficiency, cancer <5y, uncontrolled disease, substance abuse, poor venous access, cytopenias, mAb allergy, recent trials/live vaccines, pregnancy/lactation.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Intervention: Non-myeloablative autologous hematopoietic stem cell transplantation (aHSCT) with CD34+ progenitor infusion after conditioning. Conditioning drugs/types and mechanisms: cyclophosphamide (alkylating chemotherapeutic, lymphodepletes proliferating lymphocytes), thymoglobulin/ATG (polyclonal antibody, depletes T cells), rituximab (anti-CD20 monoclonal antibody, depletes B cells incl. memory B cells), corticosteroids (glucocorticoids, broad anti-inflammatory/immunosuppressive effects). Mechanistic aim: “immune reset” to reduce/eliminate anti-HLA alloantibodies and desensitize highly sensitized candidates. Targets: CD20+ B cells, plasma-cell precursors, alloreactive T cells, and humoral alloimmunity pathways (germinal center/DSA generation), followed by immune reconstitution from autologous CD34+ cells to lower cPRA and enable HLA-compatible kidney transplant offers.