A New Biomarker for the Non-invasive Diagnosis of Rejection After Heart Transplantation

NCT ID: NCT03477383

Last Updated: 2022-05-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

134 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-03-01

Study Completion Date

2021-12-31

Brief Summary

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This study is a prospective, observational multi-center cohort study. The study will consist of patients undergoing heart transplantation. The main purpose is to test a new biomarker for rejection against the gold-standard, the endomyocardial biopsy (EMB). 80 patients will be included, both children and adults.

Detailed Description

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The primary objective is a comparison of an the established, invasive diagnostic test, the endomyocardial biopsy (EMB) against a new, non-invasive test. The new test is the measurement of donor-derived cell-free DNA (dd-cfDNA) circulating in the blood stream of the recipient, quantified by droplet digital PCR (polymerase-chain reaction) after targeted multiplex preamplification. Sensitivity is calculated with EMB as the gold standard. The patients will be followed during one year post-transplantation with simultaneous blood samples and EMB. The patients will further be followed clinically for 5 years. A suitable cut-off for the ratio of dd-cfDNA will be calculated using receiver operating characteristic (ROC) analysis.

Secondary objectives are description of patient outcomes with respect to organ function, quality of life and adverse events.

Secondary objectives are the calculation of the costs related to the transplantation process as well as to the follow-up with EMB. A simulation will be done with respect to possible savings achieved if the new biomarker could be implemented.

The study consists of two cohorts: all adult recipients of heart transplantation at Sahlgrenska University Hospital (one of two center conducting heart transplantation in Sweden): regional study. The other cohort consists of all children undergoing heart transplantation in Sweden:national study. Patients will undergo transplantation at Sahlgrenska University Hospital in Gothenburg as well as at Skåne University Hospital in Lund. Follow-up with blood samples and EMB of these patients will be in Gothenburg, Lund and at Karolinska University Hospital in Stockholm.

Conditions

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Heart Transplant Rejection

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Adult patients

Adult patients (18 years or older) undergoing heart transplantation

donor-derived cell-free DNA (dd-cfDNA)

Intervention Type DIAGNOSTIC_TEST

Measurement of dd-cfDNA and comparison against grade of rejection as measured by endomyocardial biopsy, taken simultaneously

Pediatric patients

Pediatric patients (0-17 years) undergoing heart transplantation

donor-derived cell-free DNA (dd-cfDNA)

Intervention Type DIAGNOSTIC_TEST

Measurement of dd-cfDNA and comparison against grade of rejection as measured by endomyocardial biopsy, taken simultaneously

Interventions

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donor-derived cell-free DNA (dd-cfDNA)

Measurement of dd-cfDNA and comparison against grade of rejection as measured by endomyocardial biopsy, taken simultaneously

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Patient on waiting list for heart transplantation
2. Signed informed consent

Exclusion Criteria

1\. Follow-up outside Sweden
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Lund University Hospital

OTHER

Sponsor Role collaborator

Karolinska University Hospital

OTHER

Sponsor Role collaborator

Vastra Gotaland Region

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jan Sunnegårdh, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Pediatric Heart Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital

Locations

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Transplantation Center, Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Pediatric Heart Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Pediatric Heart Center, Skåne University Hospital

Lund, , Sweden

Site Status

Pediatric Heart Center, Karolinska University Hospital

Stockholm, , Sweden

Site Status

Countries

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Sweden

References

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Bohmer J, Wasslavik C, Andersson D, Stahlberg A, Jonsson M, Wahlander H, Karason K, Sunnegardh J, Nilsson S, Asp J, Dellgren G, Ricksten A. Absolute Quantification of Donor-Derived Cell-Free DNA in Pediatric and Adult Patients After Heart Transplantation: A Prospective Study. Transpl Int. 2023 Oct 30;36:11260. doi: 10.3389/ti.2023.11260. eCollection 2023.

Reference Type DERIVED
PMID: 37965628 (View on PubMed)

Other Identifiers

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014-16

Identifier Type: OTHER

Identifier Source: secondary_id

ver 1.0

Identifier Type: -

Identifier Source: org_study_id

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