Assessment of Complication Risk Factors in a French National Cohort of Asplenic Patients

NCT ID: NCT04199403

Last Updated: 2024-02-01

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

RECRUITING

Total Enrollment

6000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-01-09

Study Completion Date

2040-01-31

Brief Summary

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Spleen could have been surgically removed for trauma, cancer, auto-immune disease, or to perform a diagnosis. Spleen could be non-functional due to radiotherapy or splenic artery embolism. These patients are at risks of infectious diseases due to encapsulated bacteria, cancer, and thromboembolism disease. The purpose of this study is to assess complications occurring in French patients without spleen and to implement new diagnostic tools for follow-up.

Detailed Description

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Asplenia can be congenital or acquired. Acquired asplenia can be due to diagnostic or therapeutic surgery, splenic artery embolization, or radiotherapy. Incidence of splenectomized patients was estimated between 10 and 15/100 000 persons in 2003. More recent data suggested a decrease in splenectomy due to increase of splenic artery embolization. From 212 to 2016, about 4000 splenectomy had still been performed.

Three different risks are known for asplenic patients: infectious, neoplastic, and thromboembolic. Prevalence rate of infectious complications in splenectomized patients was 3.2% with a mortality rate of 1.4%. A US cohort study including 8149 splenectomized veterans have shown that the risk of cancer was increased, so did the risk of thromboembolic disease, on a 27-year period of follow-up. Pathophysiology of these risks are not well known.

There are very few tools to assess splenic function: Howell-Jolly bodies in red blood cells, scintigraphy. These tools lack sensitivity and are not correlated with complications in asplenic patients.

To better understand how splenic function and how immunity evolves during time in asplenic patients, a longitudinal follow-up could be useful. There may be some differences between splenectomized patients, those who benefited from splenic artery embolization, and those who received radiotherapy. Infectious risk may be different between these three groups. Implementing new tools assessing residual splenic function could improve management of these patients. A prospective follow-up aims at accurately estimate the incidence rate of infectious and non-infectious complications in this population.

Conditions

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Asplenia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Single Group

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* ≥18 year-old
* With asplenia due to splenectomy, splenic artery embolization or radiotherapy

Exclusion Criteria

* Genetic asplenia including sick cell disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pr Pierre BUFFET Institut National de la Transfusion Sanguine

UNKNOWN

Sponsor Role collaborator

Dr Edouard TUAILLON Département Bactériologie-Virologie/INSERM U1058 CHU de Montpellier

UNKNOWN

Sponsor Role collaborator

Poitiers University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mathieu PUYADE, MD

Role: PRINCIPAL_INVESTIGATOR

C.H.U. de Poitiers

Locations

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C.H. d'Angoulême

Angoulême, , France

Site Status RECRUITING

C.H. Victor Dupouy

Argenteuil, , France

Site Status RECRUITING

C.H. de Béthune

Béthune, , France

Site Status RECRUITING

Hôpitaux de Chartres

Chartres, , France

Site Status RECRUITING

C.H.U. de Lille

Lille, , France

Site Status RECRUITING

C.H.U. de Montpellier

Montpellier, , France

Site Status RECRUITING

Hôtel-Dieu - CHU de Nantes

Nantes, , France

Site Status RECRUITING

C.H.U. de Poitiers

Poitiers, , France

Site Status RECRUITING

C.H.U. de Rouen

Rouen, , France

Site Status NOT_YET_RECRUITING

C.H.U. de Toulouse

Toulouse, , France

Site Status RECRUITING

C.H. de Tourcoing

Tourcoing, , France

Site Status RECRUITING

C.H. de Valenciennes

Valenciennes, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Mathieu PUYADE, MD

Role: CONTACT

+33 5 49 44 32 76

Corinne Lorrain

Role: CONTACT

+33 5 49 44 39 30

Facility Contacts

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Agnès RICHE, MD

Role: primary

Damien CONTOU, MD

Role: primary

+33 1 34 23 11 73

NGUYEN Sophie, MD

Role: primary

Iuliana DARASTEANU, MD

Role: primary

Fanny VUOTTO, MD

Role: primary

Alain MAKINSON, MD

Role: primary

Maeva LEFEBVRE, MD

Role: primary

Mathieu PUYADE, MD

Role: primary

+33 5 49 44 2 76

Manuel ETIENNE, MD

Role: primary

Guillaume MARTIN-BLONDEL, MD

Role: primary

Nathalie VIGET, MD

Role: primary

Nicolas ETTAHAR, MD

Role: primary

References

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Kristinsson SY, Gridley G, Hoover RN, Check D, Landgren O. Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up. Haematologica. 2014 Feb;99(2):392-8. doi: 10.3324/haematol.2013.092460. Epub 2013 Sep 20.

Reference Type RESULT
PMID: 24056815 (View on PubMed)

Mebius RE, Kraal G. Structure and function of the spleen. Nat Rev Immunol. 2005 Aug;5(8):606-16. doi: 10.1038/nri1669.

Reference Type RESULT
PMID: 16056254 (View on PubMed)

Aiolfi A, Inaba K, Strumwasser A, Matsushima K, Grabo D, Benjamin E, Lam L, Demetriades D. Splenic artery embolization versus splenectomy: Analysis for early in-hospital infectious complications and outcomes. J Trauma Acute Care Surg. 2017 Sep;83(3):356-360. doi: 10.1097/TA.0000000000001550.

Reference Type RESULT
PMID: 28459796 (View on PubMed)

Other Identifiers

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SPLEEN

Identifier Type: -

Identifier Source: org_study_id

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