Lung Transplant, Post Lung Transplantation
Conditions
Keywords
Chronic Lung Allograft Dysfunction (CLAD), Restrictive chronic lung allograft dysfunction (RCLAD), Bronchiolitis Obliterans Syndrome (BOS), CLAD risk factors, observational study
Brief summary
While many patients experience benefits from transplant, complications such as infections and lung rejection may affect long term survival and quality of life. In this study doctors are looking at a complication called Chronic Lung Allograft Dysfunction (CLAD). CLAD is thought to be chronic rejection of the lung by the immune system and is the leading cause of death after lung transplantation. The purpose of this study is to help doctors determine: * why some people get CLAD and others do not * how patients who get CLAD do after CLAD is diagnosed * how CLAD may affect quality of life
Detailed description
This is an observational, prospective, multicenter study of newly transplanted adult, first lung transplant recipients that will collect longitudinal clinical data, patient reported quality of life (QOL) data, and serial biological samples to determine the risk factors, pathophysiology, and manifestations of restrictive chronic lung allograft dysfunction (RCLAD) and bronchiolitis obliterans syndrome (BOS). Anticipated participant accrual is within three years of study start-up. The total study duration is four years. Participants will be followed a minimum of 1 and a maximum of 4 years.
Interventions
PROCEDUREBlood Draw
PROCEDUREBronchoscopy
Sponsors
Clinical Trials in Organ Transplantation
National Institute of Allergy and Infectious Diseases (NIAID)
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Individuals who meet all of the following criteria are eligible for enrollment as study participants: 1. Subject must be able to understand and provide written informed consent and -Must be ≥18 years of age at the time of written informed consent. 2. Anticipated listing for lung transplantation OR within 45 days of having received a single or bilateral cadaveric donor lung transplant. \- Enrollment must occur prior to the start of bronchoscopies eligible for research bronchoalveolar lavage (BAL) sampling. 3. Undergoing first lung transplant operation. 4. Transplant surgery to be performed or performed at enrolling center. * Note: Concurrent participation in immune monitoring studies or interventional device trials are permitted.
Exclusion criteria
Individuals who meet any of the following criteria are not eligible for enrollment as study participants: 1. Multi-organ recipient. 2. Prior recipients of any solid organ transplant, including prior lung transplant. 3. Prior or concurrent recipient of bone marrow transplant. 4. HIV infection. 5. Any condition which the investigators feel would make it unlikely for the recipient to complete follow up procedures or complete the study. 6. Participation in an investigational drug trial at the time of enrollment visit.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time from transplant to Restrictive Chronic Lung Allograft Dysfunction (RCLAD) or Bronchiolitis Obliterans Syndrome (BOS). | 90 days post-transplant until study completion or participant withdrawal (up to 4 years post-transplant) | First occurrence of either phenotype. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Longitudinal Quality of life (QOL) trajectory | Baseline until study completion or participant withdrawal (up to 4 years post-transplant) | As serially assessed by the 36-item Short Form Survey (SF-36) and the St. George's Respiratory Questionnaire (SGRQ) |
| Mechanistic: Chemokine/cytokine Quantification of Type 1 and Type 17 immune profile proteins | Baseline until study completion or participant withdrawal (up to 4 years post-transplant) | Measured in the Bronchoalveolar lavage (BAL) supernatant.using standard Luminex and ELISA commercial assays |
Countries
Canada, United States
Outcome results
None listed