ECMO for Lung Transplantation in Cystic Fibrosis Patients

NCT ID: NCT03919604

Last Updated: 2019-04-18

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

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-01-01

Study Completion Date

2018-12-31

Brief Summary

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Cystic fibrosis (CF) is the most common genetically inherited disease in the Caucasian population. Bilateral lung transplantation (LUTX) is a viable option for these patients.

Frequently, the surgical operation of LUTX is complicated by hemodynamic instability, intractable hypoxia and respiratory acidosis. For these reasons, Intraoperative extracorporeal life support - ECLS- is required. Data on predictors of use of intraoperative ECLS in CF patients undergoing LUTX is scarce. Aim of this retrospective observational study was 1) to find possible risk factors at the time of enlistment associated with the intraoperative use of ECLS and 2) to compare the outcomes of CF patients treated with ECLS during LUTX or not.

Detailed Description

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Cystic fibrosis (CF) is the most common genetically inherited disease in the Caucasian population and damages multiple organ systems (i.e., upper and lower respiratory tract, pancreas, liver). Respiratory manifestations include reduction of mucus clearance, chronic pulmonary infections and bronchiectasis, causing progressive respiratory failure that is the primary cause of death in CF patients. Moreover, advanced CF is complicated by pulmonary hypertension, right ventricular hypertrophy and right heart failure. Bilateral lung transplantation (LUTX) is a viable option for these patients, providing a significant survival benefit as compared to no-LuTX.

Frequently, the surgical operation of LUTX is complicated by acute heart failure (due to sequential pulmonary artery cross-clamping and/or hemodynamic instability), severe intractable hypoxia and respiratory acidosis. For these reasons, extracorporeal life support - ECLS - (either in the form of cardiopulmonary bypass -CBP- or extracorporeal membrane oxygenation -ECMO) is frequently required.

To now, literature data on predictors of use of intraoperative ECLS in CF patients undergoing LUTX is scarce. Notably, the use of ECLS during LUTX has been associated with a higher risk of primary graft dysfunction (PGD). Moreover, knowing that a patient has a high risk for the use of ECLS may allow appropriate clinical planning of the procedure with eventual elective ECMO connection.

The investigator's Institution (Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico) is an Italian tertiary referral center for CF and LUTX, as well as for respiratory failure and ECMO support. Aim of this retrospective observational study was 1) to find possible risk factors at the time of enlistment associated with the intraoperative use of ECLS and 2) to compare the outcomes of CF patients treated with ECLS during LUTX or not.

Conditions

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Cystic Fibrosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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ECLS group

Patients with CF undergoing LUTX. Need for intraoperative extracorporeal life support

Extracorporeal Life Support

Intervention Type PROCEDURE

Any extracorporeal blood treatment technique for respiratory and/or cardiac support

Non-ECLS group

Patients with CF undergoing LUTX. No need for intraoperative extracorporeal life support

No interventions assigned to this group

Interventions

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Extracorporeal Life Support

Any extracorporeal blood treatment technique for respiratory and/or cardiac support

Intervention Type PROCEDURE

Other Intervention Names

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Extracorporeal membrane oxygenation Cardiopulmonary Bypass

Eligibility Criteria

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Inclusion Criteria

* CF
* undergoing LUTX

Exclusion Criteria

* single lung transplantation
* re-transplantation
* missing medical records.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Policlinico Hospital

OTHER

Sponsor Role lead

Responsible Party

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Giacomo Grasselli

Chief of Critical Care Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Giacomo Grasselli

Role: STUDY_DIRECTOR

Universita' di Milano

Locations

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Ospedale Maggiore Policlinico

Milan, , Italy

Site Status

Countries

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Italy

Other Identifiers

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346_2018bis

Identifier Type: -

Identifier Source: org_study_id

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