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Not yet recruitingNCT07718633IMPAKTUpdated Jul 22, 2026

Immunosuppression Optimization Using The Prospera Assay In Kidney Transplant Recipients (IMPAKT)

An interventional study of Prospera Immunosuppression Optimization in Kidney Transplant and Immunosuppresion, sponsored by Natera, Inc.. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-22.

Sponsored by Natera, Inc. · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
750
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

IMPAKT is a research study that looks at whether a blood test called Prospera™ can help doctors better adjust anti-rejection medications, compared to the usual way doctors manage these medications without using this test.

Read the detailed description

The IMPAKT study is a multi-center randomized controlled trial (RCT) in which stable low-risk kidney transplant (Tx) recipients receiving maintenance immunosuppression with tacrolimus, MPA dosage with or without corticosteroids will be randomized to the Immunosuppression optimization (Test) arm or the Standard of Care (SoC) Immunosuppression (Control) arm.

Participants will be enrolled at three months posttransplant and monitored with routine standard of care treatment and monthly Prospera blood draws from enrollment to 6 months posttransplant. All subjects will follow their center's SoC immunosuppressive therapy (IST) from enrollment to 6 months post-transplant. Subjects will be randomized at 6 months post-transplant to either the Test arm versus the Control arm.

The test arm will include participants who are managed with routine clinical care, along with a standardized dd-cfDNA protocol, to guide optimization of immunosuppression dosages. The control arm will include subjects who are managed with routine clinical care and receiving the standard of care (SoC) immunosuppression. This RCT will compare a hierarchical composite end point between the test and the control arm at 24 months post-transplant.

02

Conditions studied

  • Kidney Transplant
  • Immunosuppresion

Keywords

  • Kidney Transplant
  • Immunosuppression
03

In context

Lead sponsor

Natera, Inc. is the lead sponsor of 36 studies on the registry; 11 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Subjects received a kidney transplant in the prior 3 months.
  • Subjects receiving maintenance therapy consisting of tacrolimus, mycophenolate sodium or mycophenolate mofetil, and optionally , at the time of enrollment.
  • Subjects received induction therapy comprising IL2 receptor antagonist or thymoglobulin, or received no induction therapy.
  • 18 years of age or older at time of signing .
  • Able to read, understand and provide written informed consent, and willing and able to comply with the study requirements. If the subject is unable to sign the informed consent, a legally authorized representative (LAR) can consent on behalf of the subject.
  • Subjects are at the site standard-of-care MPA dosage

Exclusion criteria

Exclusion Criteria:

  • Concurrent multiple solid organ or tissue transplants.
  • History of a previous organ transplant (aside from present kidney transplant), or cellular transplant.
  • DSA Positive according to local protocol, including either pre-transplant DSA positivity and de novo DSA positivity.
  • Any prior dd-cfDNA results ≥1.0% or ≥78cp/mL after 28 days post-transplant.
  • ABO Incompatible donor.
  • A serious medical condition that may adversely affect ability to participate in the study (e.g, current diagnosis of cancer).
  • Pregnancy.
  • Received any induction therapy other than IL2 receptor antagonist or thymoglobulin.
  • Receiving any maintenance other than tacrolimus, mycophenolate sodium or mycophenolate mofetil, and prednisone.
  • Currently undergoing regular dialysis.
  • Considered high-risk at the time of enrollment, as per the treating physician.
  • Planned or ongoing use of other commercially available or dd-cfDNA or blood-based gene expression profile assays for rejection surveillance, through randomization.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
750 participants (estimated)

Study arms

  • No intervention
    Control Arm
  • Active comparator
    Test Arm

    Diagnostic Test: Prospera Immunosuppression Optimization

Interventions

  • Diagnostic testProspera Immunosuppression Optimization

    The test arm will include participants who are managed with routine clinical care, along with a standardized dd-cfDNA protocol, to guide optimization of immunosuppression dosages.

06

What researchers measure

Primary outcomes

  1. Tier 1: Compare the number of randomized participants who experienced death related to allograft, using a win ratio hierarchical endpoint

    The rate of death, defined as related to the allograft, in the test and control arms will be calculated and compared.

    Time frame: From enrollment to 24 months post-transplant

  2. Tier 2: Compare the number of randomized participants who experienced death censored graft loss (retransplant or return to dialysis), using a win ratio hierarchical endpoint

    The rate of graft loss, defined as return to dialysis and/or retransplant, in the test and control arms will be calculated and compared.

    Time frame: From enrollment to 24 months post-transplant

  3. Tier 3: Compare the number of randomized participants who experienced eGFR decline >30% between 6 and 24 months, using a win ratio hierarchical endpoint.

    The eGFR measurement will be calculated using the 2021 CKD-EPI formula without race.

    Time frame: From enrollment to 24 months post-transplant

  4. Tier 4: Compare the number of randomized participants who experienced biopsy proven rejection requiring treatment with intravenous medications, using a win ratio hierarchical endpoint.

    The rate of biopsy proven rejection by histology and the rate of treated rejection in the two arms between months 6 and 24 will be measured and compared.

    Time frame: From enrollment to 24 months post-transplant

  5. Tier 5: Compare the number of randomized participants who experienced transplant-related hospitalization ≥2 nights not related to biopsy proven rejection, using a win ratio hierarchical endpoint.

    The average number of nights spent at an inpatient facility for graft-related issues, but not including biopsy proven rejection, by subjects in the test and control arms will be measured and compared.

    Time frame: From enrollment to 24 months post-transplant

  6. Tier 6: Compare the number of randomized participants who developed de novo DSA after 6 months, and by 24 months, using a win ratio hierarchical endpoint.

    The rate of de novo DSA, in the test and control arms will be calculated and compared.

    Time frame: From enrollment to 24 months post-transplant

  7. Tier 7: Compare the number of randomized participants who experienced adverse outcome (AO), defined as GI Toxicity, Leukopenia, and/or Infection, using a win ratio hierarchical endpoint.

    The Adverse Outcome (AO) rate at 24 months post-Tx will be compared between the test arm and the control arm, with the list of events qualifying as AO comprising: GI toxicity, leukopenia, and infection.

    Time frame: From enrollment to 24 months post-transplant

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 22, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07718633
Lead sponsor
Natera, Inc.
Responsible party
Sponsor
First posted
Jul 22, 2026
Start date
Jul 2026 (estimated)
Primary completion
Dec 2027 (estimated)
Completion
Jul 2031 (estimated)
Last update
Jul 22, 2026

Study contacts

Natera, Inc.
Contact
impakt@natera.com
650-273-4468

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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