eligibility_summary
Adults receiving combined kidney+HSCT from HLA haplo‑matched related or ≤3‑antigen mismatched unrelated living donors. Recipients: consent, live near UCLA, KPS≥70, adequate organ function, contraception if needed. Exclusions: ABO mismatch, prior transplants, DSA, active infections (incl. HIV/HTLV), cancer, high‑recurrence renal disease, serious cardiac/liver/autoimmune disease, BMI≥40, recent immunosuppression, heavy smoking. Donors: ≥18, HLA‑matched/mismatched as above, and fit for apheresis.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
manual_review_required
ai_summary
Trial tests a combination of: oral belumosudil (KD025), donor CD34+ hematopoietic stem cells and donor CD3+ T cells, after kidney transplant with conditioning by total lymphoid irradiation (TLI) and rabbit anti‑thymocyte globulin (rATG), plus standard tacrolimus/corticosteroids/mycophenolate. Mechanisms: Belumosudil is a small‑molecule ROCK2 inhibitor that modulates T‑cell signaling—downregulates pro‑inflammatory Th17/Tfh programs and IL‑17/IL‑21, promotes FOXP3+ regulatory T cells—to enhance mixed donor chimerism and tolerance. rATG (polyclonal T‑cell–depleting antibody) and TLI deplete recipient lymphocytes to facilitate engraftment. Donor CD34+ cells reconstitute hematopoiesis, donor CD3+ cells support chimerism/tolerance. Targets: T cells—especially Treg vs Th17/Tfh balance, ROCK2 pathway, calcineurin/NFAT (tacrolimus) and lymphocyte proliferation via IMPDH (mycophenolate).