Intraoperative Versus Postoperative Thymoglobulin in Lung Transplantation
Recruitment status was Recruiting
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Purpose
The purpose of this study is to take a population of lung transplant recipients who meet UCLA criteria for induction chemotherapy with thymoglobulin and prospectively study weather giving the first dose intraoperatively versus postoperatively makes a difference with how patients do during and after lung transplantation. In addition, these cohorts will be compared to patients who do not qualify for thymoglobulin and receive either an alternative agent or no agent. The primary endpoint is primary graft dysfunction. We will also evaluate several other early and late end points such as ventilator days, ICU/hospital days, acute/chronic rejection, infection, CT chest abnormalities, and survival.
We will also collect donor lung tissue and lavage fluid for measurement of various proteins and receptor expression at two time points: (1) prior to implementation and dosing of induction chemotherapy and (2) after transplantation (following a course of induction chemotherapy). This will allow us to possibly make a connection between the profiles of the various proteins and receptors and the clinical outcomes, depending on weather the patient has received induction chemotherapy, starting intraoperatively or postoperatively.
| Condition | Intervention | Phase |
|---|---|---|
|
Lung Transplant |
Drug: rabbit antithymocyte globulin + placebo Drug: placebo + rabbit antithymocyte globulin |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Prevention |
| Official Title: | A Prospective Single Center Randomized Trial of Intraoperative Versus Postoperative Thymoglobulin in Lung Transplantation. |
- Primary Graft Dysfunction [ Time Frame: paO2/FiO2 ratio at post transplant, 24 hr, and 48 hr time points ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 120 |
| Study Start Date: | January 2006 |
| Estimated Study Completion Date: | September 2009 |
| Estimated Primary Completion Date: | September 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: I
We plan to blindly randomize these 25 lung transplant patients to intraoperative dosing of thymoglobulin followed by 3 additional postoperative doses (the first of these 3 postoperative doses will be placebo)
|
Drug: rabbit antithymocyte globulin + placebo
All patients (Arm I and Arm II) will receive 3 doses of thymoglobulin at 1.5mg/kg IV over 6 hours; only the timing of the medication is being altered. Each arm will also receive a single placebo dose. Arm I will receive thymoglobulin intraoperatively followed by a postoperative placebo dose and two subsequent thymoglobulin doses. Other Name: thymoglobulin
|
|
Experimental: II
We plan to blindly randomize these 25 lung transplant patients to 3 postoperative doses of thymoglobulin (the intraoperative dose will be placebo)
|
Drug: placebo + rabbit antithymocyte globulin
All patients (Arm I and Arm II) will receive 3 doses of thymoglobulin at 1.5mg/kg IV over 6 hours; only the timing of the medication is being altered. Each arm will also receive a single placebo dose. Arm II will receive placebo intraoperatively followed by 3 postoperative doses of thymoglobulin. |
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- On a voluntary basis, all patients eligible for bilateral lung transplantation between the ages of 18-65 years (inclusive)
Exclusion Criteria:
- Have any known allergy to horse or rabbit antithymocyte polyclonal agents
- Have a preoperative platelet count less then 100,000/mm3
- Are recipients of multiple organ transplants (either simultaneous or sequential)
- Are recipients of a single lung transplantation
- Have a contraindication to rabbit antithymocyte globulin based on judgement of the investigators (i.e. bleeding diathesis or overwhelming risk of intense immunosuppression) including the following patients: greater than 65 years of age, prior diagnosis of malignancy (with the exception skin malignancies), underlying suppurative lung disease (i.e. bronchiectasis, cystic fibrosis, etc.).
Contacts and Locations| Contact: Rajan Saggar, M.D. | 310-825-5635 | rsaggar@mednet.ucla.edu |
| Contact: Michaela Dyke | 310-825-5635 | mdyke@mednet.ucla.edu |
| United States, California | |
| Departments of Pulmonary and Critical Care, Cardiothoracic Surgery and Infectious Diseases at David Geffen School of Medicine at UCLA | Recruiting |
| Los Angeles, California, United States, 90095-1690 | |
| Contact: Rajan Saggar, M.D. 310-825-5635 rsaggar@mednet.ucla.edu | |
| Contact: Michaela Dyke 310-825-5635 mdyke@mednet.ucla.edu | |
| Principal Investigator: Rajan Saggar, M.D. | |
| Sub-Investigator: David J Ross, M.D. | |
| Sub-Investigator: John Belperio, M.D. | |
| Sub-Investigator: Joseph P Lynch, III, M.D. | |
| Sub-Investigator: Abbas Ardehali, M.D. | |
| Sub-Investigator: Bernard Kubak, MD | |
| Sub-Investigator: Rajeev Saggar, MD | |
| Sub-Investigator: Sam Weigt, MD | |
| Sub-Investigator: Aric Gregson, MD | |
| Principal Investigator: | Rajan Saggar, MD | Department of Pulmonology and Critical Care at David Geffen School of Medicine at UCLA |
More Information
No publications provided
| Responsible Party: | Rajan Saggar, David Geffen School of Medicine, UCLA |
| ClinicalTrials.gov Identifier: | NCT00592306 History of Changes |
| Other Study ID Numbers: | ATG in Lung Transplantation |
| Study First Received: | December 28, 2007 |
| Last Updated: | June 4, 2008 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of California, Los Angeles:
|
ATG rabbit thymoglobulin reperfusion lung injury primary graft dysfunction lung transplantation |
Additional relevant MeSH terms:
|
Antilymphocyte Serum Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013