Minimizing Tacrolimus in Low Immunological Risk Kidney Transplant Patients

Prospective, Multicenter, Randomized, Open-label, Parallel-group Controlled Phase 3 Study of Tacrolimus Minimization in Kidney Transplant Recipients Selected According to the AGORA Algorithm for Their Low Immunological Risk and Medium-term Graft Failure

Phase 3 Interventional Nantes University Hospital · NCT06235892

This study is testing if reducing the use of Tacrolimus, a medication for kidney transplant patients at low risk of rejection, is safe and helps keep their kidney function stable compared to the usual treatment.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment332 (estimated)
Ages18 Years and up
SexAll
SponsorNantes University Hospital Academic / other
Locations3 sites (Nantes and 2 other locations)
Trial IDNCT06235892 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to validate the AGORA algorithm, which uses non-invasive biomarkers to identify kidney transplant recipients at low immunological risk for graft failure. By selecting these patients, the study will assess the safety and efficacy of minimizing Tacrolimus, an immunosuppressive medication, compared to standard care. The primary outcome will be kidney function measured 18 months after the minimization period, focusing on patients one year post-transplantation. The trial involves multiple locations, including Nantes, Oslo, and Barcelona.

Who should consider this trial

Good fit: Ideal candidates include adult patients who have undergone their first kidney transplantation and meet specific immunological criteria indicating low risk of graft failure.

Not a fit: Patients who have had multiple kidney transplants or those with high immunological risk factors may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could lead to safer immunosuppression strategies for kidney transplant recipients, reducing the risk of side effects associated with long-term Tacrolimus use.

How similar studies have performed: Other studies have shown promise in minimizing immunosuppression in low-risk transplant patients, suggesting that this approach may be viable.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* First kidney transplantation
* Living or brain death or
* Donation after circulatory death (Maastricht 3) donor,Compatible for ABO group with the donor,
* cPRA (Panel Reactive Antibody Calculated ) (or TGI: Incompatible Graft Rate )\<20% on the day of the transplantation and no DSA (MFI \<500) at pre transplant and at the time of the inclusion at one-year post transplantation (between 350 and 515 days after the transplantation.
* Eplet Mismatchs \<= 14
* Normal or IFTA 1-2 histology on one-year surveillance biopsy.
* Patient insured under a health insurance scheme, according to national regulation.
* Patient (of childbearing age) with effective contraception.
* Patients treated with Tacrolimus (Prograf® or Advagraf®) and MMF / MPS (Mycophenolate Sodium) +/- Corticosteroid (CS)

Exclusion Criteria:

* Donation after circulatory death maastricht 2 (uncontrolled) and maastricht 1
* Pregnant women (serum or urine test), breastfeeding women
* Patient under legal protection (incl. under guardianship or trusteeship)
* Participation to a drug interventional study within 1 month prior to the inclusion
* Any retransplantation and combined transplantations and also other organ previous transplantations
* History of lymphoproliferative disorders
* Diagnosis of a malignant disease (according to the type of malignancy)
* Hepatitis C antibody or hepatitis B surface antigen (HbsAg) positive patient or HIV infection

Where this trial is running

Nantes and 2 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Organ GraftsTacrolimus minimizationkidney transplantAGORA Algorithm
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.