Lung Transplant Rejection
Conditions
Brief summary
The goal of this randomized controlled trial is to compare the diagnostic efficacy and safety of transbronchial cryobiopsy (TBCB) and traditional transbronchial lung biopsy for diagnosing the lung transplantation rejection , so as to establish the evidence-based medical basis for the effectiveness and safety of TBCB for monitoring after lung transplantation, It is expected to provide a better auxiliary examination method for lung transplantation. The main questions it aims to answer are: (1) Histopathological evaluability of specimens; (2) Safety of TBCB; (3) Size and quality of specimen, and number of attempts to obtain five samples. Participants will undergo TBCB with 1.1 mm flexible cryoprobe or traditional transbronchial lung biopsy with biopsy forceps.
Interventions
PROCEDUREtransbronchial lung cryobiopsy with a 1.1 mm flexible cryoprobe
Obtaining lung biopsy samples of patients after lung transplantation through transbronchial lung cryobiopsy with a 1.1 mm flexible cryoprobe
PROCEDUREtransbronchial lung biopsy with biopsy forceps
Obtaining lung biopsy samples of patients after lung transplantation through transbronchial lung biopsy with biopsy forceps
Sponsors
China-Japan Friendship Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age among 18-65 years old * After unilateral or bilateral lung transplantation, patient with unexplained pulmonary function decline, acute/chronic clinical lung injury or new pulmonary infiltrates * or patients requiring monitoring of rejection after lung transplantation * The patient should undertake routine preoperative examinations for lung cryobiopsy, including routine blood test, coagulation function, electrocardiogram, and chest CT, and the patients have no contraindications to cryobiopsy
Exclusion criteria
* patients intolerable to undertake lung biopsy due to severe cardiopulmonary insufficiency or being weak * The patient is allergic to lidocaine and midazolam * The patient has recent active massive hemoptysis, or the proposed biopsy site has a high risk of bleeding, such as bronchial artery penetration or suspected renal cancer lung metastasis * Unstable angina, congestive heart failure, severe bronchial asthma or multiple bullae * Severe hypertension and arrhythmia, hemodynamic instability and severe respiratory failure (PaO2\<60mmHg after oxygen therapy or mechanical ventilation) * The patient has coagulation disorder and unable to stop taking anticoagulants, antiplatelet drugs, aspirin or non-steroidal anti-inflammatory drugs before lung biopsy * Suspected aortic aneurysm * The patient does not agree to participate in this study * Participating in other studies within three months and not withdrawing or ending * The researchers think that the patient are not suitable for inclusion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diagnostic efficacy of transbronchial cryobiopsy versus traditional transbronchial lung biopsy for diagnosing the lung transplantation rejection | 7 days after lung biopsy | Diagnostic yield of transbronchial cryobiopsy (TBCB) for diagnosing the lung transplantation rejection, compare with that of traditional transbronchial lung biopsy. The reference standard is the result of Multi-Disciplinary Treatment (MDT). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sample size | during surgery | The area size of the biopsy sample will be measured using the software Image J (version 1.48; Maryland, MD, USA) , and measured in square millimetres. |
| the number of alveoli in the biopsy sample | 7 days after lung biopsy | The number of alveoli in the biopsy sample is recorded, according to the histological analysis of the biopsy paraffin section. |
| Incidence of complications | one day, 3 days and 7 days after lung biopsy | Incidence of complications |
| the percentage of the area of lung parenchyma without artifacts in the biopsy sample | 7 days after lung biopsy | The percentage of the area of lung parenchyma without artifacts in the biopsy sample is measured (by the software Image J) and recorded, according to the histological analysis of the biopsy paraffin section. |
| number of attempts to get five samples | during surgery | number of attempts to get five samples |
| the number of blood vessels in the biopsy sample | 7 days after lung biopsy | The number of blood vessels in the biopsy sample is recorded, according to the histological analysis of the biopsy paraffin section. |
Contacts
Primary ContactRun Tong, MD
Outcome results
None listed