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Normothermic Ex Vivo Lung Perfusion (EVLP) For An Improved Assessment of Donor Lungs For Transplantation (HELP)

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ClinicalTrials.gov Identifier: NCT01190059
Recruitment Status : Completed
First Posted : August 27, 2010
Last Update Posted : November 16, 2010
Sponsor:
Information provided by:
XVIVO Perfusion

Brief Summary:
The use of ex vivo lung perfusion (EVLP) will allow for a secondary evaluation technique for donor lungs that fail to meet standard acceptability criteria. This advanced assessment might lead to increased utilization rates of donor lungs and improved outcomes after lung transplantation.

Condition or disease Intervention/treatment Phase
Lung Transplantation Drug: Ex vivo lung perfusion with Steen Solution™ Phase 1

Detailed Description:

Human donor lungs that do not meet the standard clinical criteria for donor lung utilization but fit into the study inclusion criteria will be retrieved from the donor using current donor lung retrieval techniques.

These lungs will be brought to the study transplant center to be re-assessed by the transplant team. The lungs will be physiologically assessed during ex vivo perfusion with Steen Solution. Perfusion of these lungs will be performed using Steen solution with the addition of methylprednisolone, heparin and antibiotics. With respect to the decision of lung utilization those organs with a delta pO2 (Δ pO2 = Pulmonary vein pO2 - pulmonary artery pO2) during ex vivo perfusion assessment > 350mmHg, good lung compliance, and a favorable opinion of the transplant surgeon will be considered transplantable. Lungs will be excluded for transplantation: if the Δ pO2 is less than 350mmHg or if they demonstrate >10% deterioration in any of the following functional parameters: pulmonary vascular resistance (PVR), dynamic compliance or airway pressures. Lungs will also be excluded if they are deemed unsuitable based on the clinical judgment of the lung transplant surgeon.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 22 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Normothermic Ex Vivo Lung Perfusion (EVLP) For An Improved Assessment of Donor Lungs For Transplantation
Study Start Date : August 2008
Primary Completion Date : February 2010
Study Completion Date : February 2010

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arm Intervention/treatment
Experimental: EVLP Group
EVLP Group are those recipient lung transplant patients that received donor lungs that had been placed on the ex vivo lung perfusion system with Steen Solution™ .
Drug: Ex vivo lung perfusion with Steen Solution™
The circuit is primed with 2,000cc Steen Solution™. At one hour of EVLP, 500 cc of circulated perfusate was removed and replenished with 500 cc of fresh perfusate. After that, 250 cc of perfusate was exchanged every hour.



Primary Outcome Measures :
  1. PGD scores in the first 72 hours after lung transplantation. [ Time Frame: 72 hours ]
    Immediate lung function is one of the key factors in determining the impact of donor lung quality, therefore the PGD score within 72 hrs was selected as the primary endpoint.

  2. 30 day Mortality [ Time Frame: 30 days ]
    Mortality at 30 days post transplant


Secondary Outcome Measures :
  1. Extra-corporeal membrane oxygenation use [ Time Frame: 30 days ]
    If the patient needed to be placed on extra-corporeal membrane oxygenation after transplantation.

  2. Bronchial complications [ Time Frame: 30 days ]
    To see if there was an increased risk for bronchial complications

  3. Ventilator duration [ Time Frame: 30 days ]
    How long was the patient on the ventilator after lung transplantation and was there an increased time on ventilator for the patient after EVLP.

  4. Intensive Care Unit length of stay [ Time Frame: 30 days ]
  5. Hospital length of stay [ Time Frame: 30 days ]
    Time in the hospital



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria for donor lung:

  1. Recipient to undergo a single or bilateral Lung Transplantation
  2. Last donor PaO2/FiO2 ≤ 300mmHg
  3. Poor oxygenation and/or poor lung compliance is the primary reason for unsuitability
  4. Absence of pneumonia, persistent purulent secretion on bronchoscopy or significant mechanical trauma

Exclusion Criteria:

  1. Infection
  2. Aspiration
  3. Significant mechanical lung injury - contusion
  4. Infectious diseases : HIV, Hepatitis B and C, HTLV & Syphilis
  5. Malignancy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01190059


Locations
Canada, Ontario
Toronto General Hospital
Toronto, Ontario, Canada, M5G 1Z5
Sponsors and Collaborators
XVIVO Perfusion
Investigators
Principal Investigator: Shaf Keshavjee, MD,MSc,FRCSC University of Toronto-Toronto General Hospital

Publications:
D.M. Karamanou, H.R. Walden, S. Bean, et al. The Effect of Ex-Vivo Perfusion on the Inflammatory Profile of the Donor Lung. J Heart Lung Transplant 2010:Vol. 29, Issue 2, Supplement, Page S165.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Dr. Shaf Keshavjee, University of Toronto-Toronto General Hospital
ClinicalTrials.gov Identifier: NCT01190059     History of Changes
Other Study ID Numbers: VIT-001-TOR
139150 ( Other Identifier: Health Canada )
First Posted: August 27, 2010    Key Record Dates
Last Update Posted: November 16, 2010
Last Verified: November 2010

Keywords provided by XVIVO Perfusion:
Lung
Transplantation
Lung Transplantation
Transplantation Lung

Additional relevant MeSH terms:
Pharmaceutical Solutions