Study of Organ Perfusion in Heart Transplantation in Children
Study Details
Study Description
Brief Summary
The goal of this prospective randomized single blind multicenter phase II study is to compare organ perfusion with Custodiol-N and Custodiol in heart transplantation in children of all ages (birth to <18 years) being listed on the waiting list for heart transplantation. The main question it aims to answer is:
to compare the safety of Custodiol-N in heart transplantation in children in comparison to its precursor product Custodiol.
Participants will receive either a heart to be transplanted, either perfused with Custodiol-N or Custodiol to Researchers will compare the two solutions to see if the new solution Custodiol-N is safe in heart transplantation in children.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
| Phase 2 |
Detailed Description
Orthotopic Heart transplantation (or cardiac transplantation) is a procedure performed in patients with end stage heart failure when other treatments have failed.
The surgical procedures for orthotopic heart transplantation are essentially the same in adult and paediatric patients . Due to anatomical variants in congenital heart disease the procurement procedure may be modified with regard to the extent of the Vena cava superior and the great vessels. In implantation most frequently the bicaval technique is used but the biatrial technique which is leaving the back wall of both atria in situ may also be employed.
A main difference between adult and paediatric heart transplantation (HTx) are the indications for transplantation: In adults the majority of patients undergo HTx as treatment of end stage heart failure due to cardiomyopathy or severe coronary artery disease when other treatments have failed. Infants younger than one year of age congenital heart disease (CHD) is the most common diagnosis representing more than every second case followed by dilated cardiomyopathy (DCM) in more than one third of cases. In older patients DCM is the most frequent underlying diagnosis. CHD may include patients who have undergone corrective surgery and in whom myocardial dysfunction develops later .
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Custodiol-N organ will be perfused with Custodiol-N solution |
Drug: Custodiol-N
heart will preserved in and will be treated with Custodiol-N solution
Other Names:
|
| Active Comparator: Custodiol organ will be perfused with Custodiol solution |
Drug: Custodiol
heart will preserved in and will be treated with Custodiol solution
Other Names:
|
Outcome Measures
Primary Outcome Measures
- adverse event reporting [up to 3 months]
Safety assessment
Secondary Outcome Measures
- heart rate [up to day 7 after release of the aortic cross clamp]
vital parameters
- blood pressure (systolic (SBP) and diastolic (DBP)) [up to day 7 after release of the aortic cross clamp]
vital parameters
- body temperature [up to day 7 after release of the aortic cross clamp]
vital parameters
- concentration of cardiac troponin [up to day 7 after release of the aortic cross clamp]
laboratory tests
- concentration of creatinine kinase (CK-MB) [up to day 7 after release of the aortic cross clamp]
laboratory tests
- (SBP (systolic blood pressure), DBP (diastolic blood pressure)) [from termination of cardiopulmonary bypass until transfer to intensive care unit]
Haemodynamics
- Heart Rhythm (HR) [from termination of cardiopulmonary bypass until transfer to intensive care unit]
Haemodynamics
- Pulmonary artery pressure (PAP (if available)) [from termination of cardiopulmonary bypass until transfer to intensive care unit]
Haemodynamics
- Cerebrovascular resistance (CVR (if available)) [from termination of cardiopulmonary bypass until transfer to intensive care unit]
Haemodynamics
- Death [up to 12 months]
survival
- function of transplanted organ (heart) [up to 3 months]
Graft survival
- Readmission to intensive care unit (ICU) [up to 3 months]
return to intensive care unit
- Length of ICU stays [up to 3 months]
duration of stay in intensive care unit
- Catecholamine requirement [up to day 7]
(yes/no)
- Antihypertensives intake [up to 12 months]
(yes/no)
- Milrinone support [up to day 7]
(yes/no)
- Need for pacemaker therapy [up to day 7]
(yes/no)
- Left and right ventricular assist device (LVAD, RVAD) [up to 3 months]
Device therapy (each yes/no)
- Extracorporeal membrane oxygenation (ECMO) [up to 3 months]
Device therapy (each yes/no)
- Biventricular assist Device (BIVAD) or percutaneous LVAD [up to 3 months]
Device therapy (each yes/no)
- Ejection fraction [up to day 7]
Echocardiographic markers of function and rejection
- enddiastolic and endsystolic ventricle [up to day 7]
Echocardiographic markers of function and rejection
- Cardiac arrhythmias [up to day 7]
occurrence, severity, type
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age from birth to less than18 years
-
Recipients awaiting their first transplant
-
Ability of the patients and/ or their legal guardians to understand character and individual consequences of the clinical trial
-
written informed consent of the patients and/ or their legal guardians (must be available before enrolment in the study)
-
Patient listed on the waiting list for heart transplantation
Exclusion Criteria:
-
Patients who have participated within 30 days or are still participating in any other interventional studies
-
history of severe organic disease other than concerning the heart
-
history/demonstration of HIV antibodies or AIDS
-
multiorgan transplantation
-
machine-perfused organ
-
the explantation team is affiliated to another clinic than transplantation team
-
Failing Fontan patients
-
Patients who have been incarcerated or involuntarily institutionalized by court order or by the authorities
-
Pregnancy and lactation
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Deutsches Herzzentrum der Charité | Berlin | Germany | 13353 | |
| 2 | Universitätsklinikum Gießen (UKGM), Kinderherzzentrum, Klinikum für Kinderherzchirurgie | Gießen | Germany | 35385 | |
| 3 | Klinikum der Universität München (LMU), Klinik und Poliklinik für Herzchirurgie, Chirurgische Klinik | München | Germany | 81377 |
Sponsors and Collaborators
- Dr. F. Köhler Chemie GmbH
Investigators
- Principal Investigator: Christoph Knosalla, Prof. Dr., German Heart Institute
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CL-N-HTX-Paed-II/10/20