Recruiting
Early Phase 1

Renal & Urinary Bladder

Sponsor:

Mayo Clinic

Code:

NCT04626167

Conditions

Chronic Kidney Diseases

Bladder Dysfunction

Bladder Absence

Posterior Urethral Valve

Neurogenic Bladder

Eligibility Criteria

Sex: All

Age: 1 - 60

Healthy Volunteers: Not accepted

Interventions

Concomitant Renal and Urinary Bladder Allograft Transplantation

Study Details

Brief summary:

The purpose of this study is to establish if concomitant renal and vascularized urinary bladder allograft transplantation is feasible.

Conditions

Chronic Kidney Diseases

Bladder Dysfunction

Bladder Absence

Posterior Urethral Valve

Neurogenic Bladder

Study ID

NCT04626167

Start date

Jun 1, 2021

Status verified date

Apr, 2026

Completion date

Aug, 2026

Anticipated

Primary completion date

Aug, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 1 - 60

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Male or female patients between 1 yr. and 60 years of age.
  • Subject is willing and able to give signed informed consent, or have a legally authorized representative who is willing and able to give consent. Informed assent will be required for children 6-17 years of age as appropriate or warranted.
  • Patients with CKD secondary to neurogenic bladder, lower urinary tract obstruction or other disorders of the urinary bladder.
  • Medical need for a bladder transplant, as defined by the presence of exhibiting "hostile bladders" defined as end filling pressure or detrusor leak point pressure (DLPP) of or greater than 40 cm H20 or at below estimated bladder capacity for age, or detrusor overactivity with detrusor sphincter dyssynergia, or new onset of upper urinary tract changes (hydronephrosis, vesicoureteral reflux) in the last 12 months
  • If a concomitant kidney transplant is being considered, additionally, estimated GFR less than or equal to 20 mL/min or dialysis. If GFR 20-25 mL/min would also qualify if expected progression is rapid (>10 mL/min/year)
  • Vetting and approval by the Mayo Clinic multidisciplinary transplant team (MDC) for renal transplantation.
  • Ability of subject and/or care provider to be successfully trained in clean intermittent catheterization and bladder cycling. Or current use of CIC.
  • Utilization of maximally-tolerated dose and regimen of medical therapy (e.g. anticholinergics) or failure to tolerate/contraindications to such agents.
  • Psychosocial clearance: Demonstrated commitment to psychological evaluation perioperatively, in which the psychologist must confirm that the subject has the maturity and stable psychosocial environment necessary for this research study.
  • Agree to avoid pregnancy for 1 year after surgery through abstinence or approved contraception as noted in Appendix A (female subjects only)
  • If patient has a history of malignancy (with the exception of localized non-melanoma skin cancer) the patient must be at least 5 years from termination of treatment without evidence of recurrent disease.

Exclusion Criteria:

  • They are pregnant or breastfeeding, or planning a pregnancy during the course of the study, or who are of child bearing potential and not willing to continue using an effective method of birth control (i.e. with a low failure rate of less than 1 percent per year including injectables, combined oral contraceptives, some intrauterine devices, sexual abstinence, or a vasectomized partner), or
  • Any contraindication to general anesthesia or evaluation reveals that the subject cannot safely undergo general anesthesia and post-operative recovery due to severe cardiovascular, pulmonary, neurological, metabolic, or rheumatologic disease (requires special consultation)
  • Any contraindication or known anaphylactic or severe systemic reaction to either human blood products or materials of bovine origin
  • Subjects with a current positive (>=5 mm induration for high-risk subjects; otherwise >=10 mm of induration) purified protein derivative (PPD) test are excluded unless they have completed a full course of treatment for latent TB and have a negative chest x-ray film at enrollment.
  • Known history of hypersensitivity to aminoglycosides or fluoroquinolones
  • Use of any investigational product within 3 months
  • Prior participation in the study
  • Currently smoking
  • Current incarceration for any reason
  • Unwillingness, inability, or unlikely compliance of individual and/or primary caregiver with study related schedules procedures, management, or follow -up in the opinion of the PI and/or co-investigators
  • Any circumstance in which the investigator deems participation in the study is not in the subject's best interest
  • Subjects with an ALT or AST value >3 times the upper limit of normal
  • Subjects with acute or chronic abdominal skin infections and/or acute or chronic abdominal inflammatory conditions such as inflammatory bowel disease
  • Subjects with uncontrolled diabetes defined as HgA1c>10, unstable cardiac and/or pulmonary disorders, or bleeding disorders
  • Active malignant neoplasm (with the exception of localized non-melanoma skin cancer) that is untreated, unresponsive to available treatment, or too recently treated to determine relapse risk.
  • Surgical procedure for transplantation cannot be successfully performed for anatomical reasons
  • Life expectancy with successful transplantation is estimated to be <5 years for any reason.
  • There is any other disease, physical examination finding, or clinical laboratory result that provides a reasonable suspicion of a disease or condition that contraindicates the procedure or the interpretation of results or render the subject at high risk for treatment complications, or
  • Serious or uncontrolled psychiatric illness or disorder that could compromise their understanding of, or compliance with, follow-up visits/care after transplant, or
  • Taking medications on specified hourly intervals that may be affected by changes to renal clearance, or
  • Hypertension stage II > 99th percentile, unless they had a complete workup to exclude secondary etiologies other than being overweight, or
  • Presence of severe coagulopathy, (hyper or hypo)
  • Patient is not up to date on current CDC recommended vaccines

Study Design

Enrollment

30 participants

Anticipated

Intervention Model

Single group

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Intervention group

Patients will undergo a cadaveric donor bladder transplant in addition to or after their kidney transplant rather than using intestinal segments for bladder reconstruction or construction.

Interventions

Concomitant Renal and Urinary Bladder Allograft Transplantation

This is a single-center, prospective, single-group unblinded phase I study that will enroll subjects with chronic kidney disease secondary to bladder dysfunction or bladder absence that is refractory to medical treatment and requires surgical intervention to prevent long-term sequelae. Patients will undergo a cadaveric donor bladder transplant in addition to or after their kidney transplant rather than using intestinal segments for bladder reconstruction or contruction.

Primary outcome measure

  • Establish if concomitant renal and vascularized urinary bladder allograft transplantation is feasible. [ Time Frame: Year 1-4 ]
  • Study the long term function of vascularized bladder allotransplantation in patients receiving a concomitant renal and bladder graft [ Time Frame: Year 1-4 ]

Central Contacts and Locations

Central contacts

Vidhu Joshi

(507) 538-5772Kroeninger.Tessa@mayo.edu

Patricio Gargollo, MD

gargollo.patricio@mayo.edu

Locations

Mayo Clinic

Recruiting

Rochester, Minnesota, United States, 55901

Contacts

Tessa Kroeninger

(507)538-6107Kroeninger.Tessa@mayo.edu

Mayo Clinic in Rochester

Recruiting

Rochester, Minnesota, United States, 55905

More Information

Sponsor

Mayo Clinic

Last update posted

Apr 23, 2026

Last verified

Apr, 2026

Keywords

  • Urinary Bladder Transplant
  • Bladder Transplant
  • Bladder Augment
  • Neobladder
  • Ileocystoplasty

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by Mayo Clinic on 2026-04-23.