Heart TransplantationDHSNCT02376387
Evidence Based Evaluation and Acceptance of Donor Hearts for Transplantation
An observational study of Heart Transplantation, run by Stanford University at 10 sites in United States.
Trial summary
The proposed research will provide evidence-based strategies for the evaluation and acceptance of donor hearts for transplantation. This is relevant to public health because judicious expansion of donor hearts used for transplantation will make this life-saving procedure available to a larger number of patients living… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Heart Transplantation
- How many people
- 4,333 participants
- Where
- 10 sitesUnited States
- Study dates
- Mar 2015to 26 May 2020
- How long will I take part?
- 5 Years
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Brain dead donors for heart transplant
Who may be able to join
- Brain dead (beating heart)
- 18-65 years of age
- HIV (-)
- Donors authorized for research
Who cannot join
- Donors not authorized for research
- HIV (+)
Trial locations and contacts
10 sites in 1 country.
10 sites in 1 country
United States10 sites
Gift of Life
Ann Arbor, Michigan, 48108
LifeGift
Houston, Texas, 77054
Gift of Hope
Itasca, Illinois, 60143
LifeLink
Norcross, Georgia, 30071
California Transplant Donor Network
Oakland, California, 94607
Donor Network of Arizona
Phoenix, Arizona, 85013
Oregon Health and Science University
Portland, Oregon, 97239
Kaiser Permanente
San Francisco, California, 94115
Stanford University
Stanford, California, 94305
New England Organ Bank
Waltham, Massachusetts, 02451
About this study
The proposed research will provide evidence-based strategies for the evaluation and acceptance of donor hearts for transplantation. This is relevant to public health because judicious expansion of donor hearts used for transplantation will make this life-saving procedure available to a larger number of patients living with end-stage heart disease.
Read the detailed description
The demand for donor hearts for transplantation far outstrips the supply; however, only one in three available cardiac grafts are used for transplantation. There are many reasons for graft non-use, but previous studies have failed to demonstrate consistent associations between donor characteristics, donor cardiac function, and adverse recipient outcomes. Thus, there is a critical need to standardize how cardiac allografts are evaluated and accepted for transplantation. The investigators long-term goal is to safely expand the use of available cardiac allografts without adversely affecting transplant recipient outcomes. The investigators propose to carefully characterize the current population of cardiac organ donors, particularly with regards to allograft function; to examine how decisions are made regarding graft acceptance for transplantation; and to systematically evaluate associations between donor characteristics and recipient outcomes. The investigators central hypothesis is that acceptable allografts for heart transplantation are being unnecessarily discarded, and the establishment of an evidence-based process for cardiac donor evaluation and acceptance will increase graft utilization rates while maintaining excellent clinical outcomes. In response to this need, the investigators propose a collaborative study with seven organ procurement organizations representing geographically diverse regions of the United States, to address the following specific aims: (1) To identify clinical correlates of graft function in potential donors being evaluated for heart transplantation. An existing online donor research database will be expanded for standardized collection of data on detailed donor characteristics, especially as pertains to cardiac allograft function. The investigators will perform expert core review of donor echocardiograms, including serial echocardiograms in donors with cardiac allograft dysfunction. Serial electrocardiograms and cardiac biomarkers (Troponin I and B-type natriuretic peptide) will also be studied; (2) To prospectively study reasons for cardiac allograft non-utilization for heart transplantation. Real-time data will be collected on specific reasons for allograft non-acceptance for transplantation in order to study graft acceptance practices and variation in graft utilization nationwide; and (3) To prospectively study associations between donor characteristics and recipient outcomes after heart transplantation. Data will be collected on recipient post-transplant length of hospitalization and survival to identify associations between donor predictors and recipient outcomes. This proposal is innovative because it focuses on an entirely different approach to donor-based research, thereby surmounting the limitations of prior investigations. Completion of the proposed study will have a positive impact by defining how to optimize the evaluation and use of available grafts for heart transplantation, thereby safely expanding the donor pool and increasing the number of heart transplants performed nationwide.
- Conditions
- Heart Transplantation
What is being measured
The primary outcome is the main question the study is designed to answer.
Donor left ventricular ejection fraction, troponin, BNP, EKG changes (arrhythmias, QT prolongation, repolarization abnormalities, LVH, Q waves)
To identify clinical correlates of cardiac function in potential donors being evaluated for heart transplantation.
Measured: 5 years
Identify decline codes for donor hearts not accepted for transplant
To prospectively study reasons for non-acceptance of hearts offered for transplantation.
Measured: 5 years
Create a statistical tools (e.g. risk prediction model) for donor heart acceptance
To develop clinical tools to assist transplant centers with real-time decisions regarding donor heart acceptance.
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Mar 2015 (estimated)
- Study startMar 2015
- Primary completion26 May 2020
- Study completion26 May 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Heart TransplantationStudies of the same condition, open and under way.
- More trials run by Stanford UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 4,333 participants (actual)
- Target duration
- 5 Years
Sponsor and investigators
- Lead sponsor
- Stanford University
- Sponsor type
- University, hospital or other
- Collaborators
- Oregon Health and Science University, Kaiser Permanente, California Transplant Donor Network, Donor Network of Arizona, Gift of Life, Gift of Hope, LifeLink, New England Organ Bank, Life Gift Organ Donation, National Institutes of Health (NIH)
- Responsible party
- Principal investigator, Kiran Khush, Stanford University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02376387
- Sponsor's protocol ID
- NIH 41169
- Acronym
- DHS
- Status last verified
- Oct 2021
- First submitted
- 17 Feb 2015
- Last updated
- 21 Oct 2021
- Results posted
- No
- Data monitoring committee
- No
Publications
Khush KK, Menza R, Nguyen J, Zaroff JG, Goldstein BA. Donor predictors of allograft use and recipient outcomes after heart transplantation. Circ Heart Fail. 2013 Mar;6(2):300-9. doi: 10.1161/CIRCHEARTFAILURE.112.000165. Epub 2013 Feb 7.
PubMed 23392789Shah MR, Starling RC, Schwartz Longacre L, Mehra MR; Working Group Participants. Heart transplantation research in the next decade--a goal to achieving evidence-based outcomes: National Heart, Lung, And Blood Institute Working Group. J Am Coll Cardiol. 2012 Apr 3;59(14):1263-9. doi: 10.1016/j.jacc.2011.11.050.
PubMed 22464255Chen JM, Sinha P, Rajasinghe HA, Suratwala SJ, McCue JD, McCarty MJ, Caliste X, Hauff HM, John R, Edwards NM. Do donor characteristics really matter? Short- and long-term impact of donor characteristics on recipient survival, 1995-1999. J Heart Lung Transplant. 2002 May;21(5):608-10. doi: 10.1016/s1053-2498(01)00367-9.
PubMed 11983553De La Zerda DJ, Cohen O, Beygui RE, Kobashigawa J, Hekmat D, Laks H. Alcohol use in donors is a protective factor on recipients' outcome after heart transplantation. Transplantation. 2007 May 15;83(9):1214-8. doi: 10.1097/01.tp.0000261713.24244.ea.
PubMed 17496538Lima B, Rajagopal K, Petersen RP, Shah AS, Soule B, Felker GM, Rogers JG, Lodge AJ, Milano CA. Marginal cardiac allografts do not have increased primary graft dysfunction in alternate list transplantation. Circulation. 2006 Jul 4;114(1 Suppl):I27-32. doi: 10.1161/CIRCULATIONAHA.105.000737.
PubMed 16820584Nixon JL, Kfoury AG, Brunisholz K, Horne BD, Myrick C, Miller DV, Budge D, Bader F, Everitt M, Saidi A, Stehlik J, Schmidt TC, Alharethi R. Impact of high-dose inotropic donor support on early myocardial necrosis and outcomes in cardiac transplantation. Clin Transplant. 2012 Mar-Apr;26(2):322-7. doi: 10.1111/j.1399-0012.2011.01504.x. Epub 2011 Oct 10.
PubMed 21981698Patel ND, Weiss ES, Nwakanma LU, Russell SD, Baumgartner WA, Shah AS, Conte JV. Impact of donor-to-recipient weight ratio on survival after heart transplantation: analysis of the United Network for Organ Sharing Database. Circulation. 2008 Sep 30;118(14 Suppl):S83-8. doi: 10.1161/CIRCULATIONAHA.107.756866.
PubMed 18824775Smits JM, De Pauw M, de Vries E, Rahmel A, Meiser B, Laufer G, Zuckermann A. Donor scoring system for heart transplantation and the impact on patient survival. J Heart Lung Transplant. 2012 Apr;31(4):387-97. doi: 10.1016/j.healun.2011.11.005. Epub 2011 Dec 16.
PubMed 22177692Weiss ES, Allen JG, Kilic A, Russell SD, Baumgartner WA, Conte JV, Shah AS. Development of a quantitative donor risk index to predict short-term mortality in orthotopic heart transplantation. J Heart Lung Transplant. 2012 Mar;31(3):266-73. doi: 10.1016/j.healun.2011.10.004. Epub 2011 Nov 16.
PubMed 22093382Wever Pinzon O, Stoddard G, Drakos SG, Gilbert EM, Nativi JN, Budge D, Bader F, Alharethi R, Reid B, Selzman CH, Everitt MD, Kfoury AG, Stehlik J. Impact of donor left ventricular hypertrophy on survival after heart transplant. Am J Transplant. 2011 Dec;11(12):2755-61. doi: 10.1111/j.1600-6143.2011.03744.x. Epub 2011 Sep 11.
PubMed 21906259
Study at a glance
From the registry record, last updated by the sponsor on 21 Oct 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evidence Based Evaluation and Acceptance of Donor Hearts for Transplantation
- ClinicalTrials.gov ID
- NCT02376387
- Acronym / sponsor ID
- DHS / NIH 41169
- Conditions
- Heart Transplantation
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 4,333 participants (actual)
- Lead sponsor
- Stanford UniversityUniversity, hospital or other
- Collaborators
- Oregon Health and Science University, Kaiser Permanente, California Transplant Donor Network, Donor Network of Arizona, Gift of Life, Gift of Hope, LifeLink, New England Organ Bank, Life Gift Organ Donation, National Institutes of Health (NIH)
- Study start
- Mar 2015 (actual)
- Primary completion
- 26 May 2020 (actual)
- Study completion
- 26 May 2020 (actual)
- First posted
- 3 Mar 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The proposed research will provide evidence-based strategies for the evaluation and acceptance of donor hearts for transplantation. This is relevant to public health because judicious expansion of donor hearts used for transplantation will make this life-saving procedure available to a larger number of patients living with end-stage heart disease.
Detailed description
The demand for donor hearts for transplantation far outstrips the supply; however, only one in three available cardiac grafts are used for transplantation. There are many reasons for graft non-use, but previous studies have failed to demonstrate consistent associations between donor characteristics, donor cardiac function, and adverse recipient outcomes. Thus, there is a critical need to standardize how cardiac allografts are evaluated and accepted for transplantation. The investigators long-term goal is to safely expand the use of available cardiac allografts without adversely affecting transplant recipient outcomes. The investigators propose to carefully characterize the current population of cardiac organ donors, particularly with regards to allograft function; to examine how decisions are made regarding graft acceptance for transplantation; and to systematically evaluate associations between donor characteristics and recipient outcomes. The investigators central hypothesis is that acceptable allografts for heart transplantation are being unnecessarily discarded, and the establishment of an evidence-based process for cardiac donor evaluation and acceptance will increase graft utilization rates while maintaining excellent clinical outcomes. In response to this need, the investigators propose a collaborative study with seven organ procurement organizations representing geographically diverse regions of the United States, to address the following specific aims: (1) To identify clinical correlates of graft function in potential donors being evaluated for heart transplantation. An existing online donor research database will be expanded for standardized collection of data on detailed donor characteristics, especially as pertains to cardiac allograft function. The investigators will perform expert core review of donor echocardiograms, including serial echocardiograms in donors with cardiac allograft dysfunction. Serial electrocardiograms and cardiac biomarkers (Troponin I and B-type natriuretic peptide) will also be studied; (2) To prospectively study reasons for cardiac allograft non-utilization for heart transplantation. Real-time data will be collected on specific reasons for allograft non-acceptance for transplantation in order to study graft acceptance practices and variation in graft utilization nationwide; and (3) To prospectively study associations between donor characteristics and recipient outcomes after heart transplantation. Data will be collected on recipient post-transplant length of hospitalization and survival to identify associations between donor predictors and recipient outcomes. This proposal is innovative because it focuses on an entirely different approach to donor-based research, thereby surmounting the limitations of prior investigations. Completion of the proposed study will have a positive impact by defining how to optimize the evaluation and use of available grafts for heart transplantation, thereby safely expanding the donor pool and increasing the number of heart transplants performed nationwide.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 5 Years
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Brain dead donors for heart transplant
Key inclusion criteria (4 listed)
- Brain dead (beating heart)
- 18-65 years of age
- HIV (-)
- Donors authorized for research
Key exclusion criteria (2 listed)
- Donors not authorized for research
- HIV (+)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Donor left ventricular ejection fraction, troponin, BNP, EKG changes (arrhythmias, QT prolongation, repolarization abnormalities, LVH, Q waves)
Time frame: 5 years
To identify clinical correlates of cardiac function in potential donors being evaluated for heart transplantation.
Identify decline codes for donor hearts not accepted for transplant
Time frame: 5 years
To prospectively study reasons for non-acceptance of hearts offered for transplantation.
Create a statistical tools (e.g. risk prediction model) for donor heart acceptance
Time frame: 5 years
To develop clinical tools to assist transplant centers with real-time decisions regarding donor heart acceptance.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Oct 2021.
- Background: PubMed 23392789Khush KK, Menza R, Nguyen J, Zaroff JG, Goldstein BA. Donor predictors of allograft use and recipient outcomes after heart transplantation. Circ Heart Fail. 2013 Mar;6(2):300-9. doi: 10.1161/CIRCHEARTFAILURE.112.000165. Epub 2013 Feb 7.
- Background: PubMed 22464255Shah MR, Starling RC, Schwartz Longacre L, Mehra MR; Working Group Participants. Heart transplantation research in the next decade--a goal to achieving evidence-based outcomes: National Heart, Lung, And Blood Institute Working Group. J Am Coll Cardiol. 2012 Apr 3;59(14):1263-9. doi: 10.1016/j.jacc.2011.11.050.
- Background: PubMed 11983553Chen JM, Sinha P, Rajasinghe HA, Suratwala SJ, McCue JD, McCarty MJ, Caliste X, Hauff HM, John R, Edwards NM. Do donor characteristics really matter? Short- and long-term impact of donor characteristics on recipient survival, 1995-1999. J Heart Lung Transplant. 2002 May;21(5):608-10. doi: 10.1016/s1053-2498(01)00367-9.
- Background: PubMed 17496538De La Zerda DJ, Cohen O, Beygui RE, Kobashigawa J, Hekmat D, Laks H. Alcohol use in donors is a protective factor on recipients' outcome after heart transplantation. Transplantation. 2007 May 15;83(9):1214-8. doi: 10.1097/01.tp.0000261713.24244.ea.
- Background: PubMed 16820584Lima B, Rajagopal K, Petersen RP, Shah AS, Soule B, Felker GM, Rogers JG, Lodge AJ, Milano CA. Marginal cardiac allografts do not have increased primary graft dysfunction in alternate list transplantation. Circulation. 2006 Jul 4;114(1 Suppl):I27-32. doi: 10.1161/CIRCULATIONAHA.105.000737.
- Background: PubMed 21981698Nixon JL, Kfoury AG, Brunisholz K, Horne BD, Myrick C, Miller DV, Budge D, Bader F, Everitt M, Saidi A, Stehlik J, Schmidt TC, Alharethi R. Impact of high-dose inotropic donor support on early myocardial necrosis and outcomes in cardiac transplantation. Clin Transplant. 2012 Mar-Apr;26(2):322-7. doi: 10.1111/j.1399-0012.2011.01504.x. Epub 2011 Oct 10.
- Background: PubMed 18824775Patel ND, Weiss ES, Nwakanma LU, Russell SD, Baumgartner WA, Shah AS, Conte JV. Impact of donor-to-recipient weight ratio on survival after heart transplantation: analysis of the United Network for Organ Sharing Database. Circulation. 2008 Sep 30;118(14 Suppl):S83-8. doi: 10.1161/CIRCULATIONAHA.107.756866.
- Background: PubMed 22177692Smits JM, De Pauw M, de Vries E, Rahmel A, Meiser B, Laufer G, Zuckermann A. Donor scoring system for heart transplantation and the impact on patient survival. J Heart Lung Transplant. 2012 Apr;31(4):387-97. doi: 10.1016/j.healun.2011.11.005. Epub 2011 Dec 16.
- Background: PubMed 22093382Weiss ES, Allen JG, Kilic A, Russell SD, Baumgartner WA, Conte JV, Shah AS. Development of a quantitative donor risk index to predict short-term mortality in orthotopic heart transplantation. J Heart Lung Transplant. 2012 Mar;31(3):266-73. doi: 10.1016/j.healun.2011.10.004. Epub 2011 Nov 16.
- Background: PubMed 21906259Wever Pinzon O, Stoddard G, Drakos SG, Gilbert EM, Nativi JN, Budge D, Bader F, Alharethi R, Reid B, Selzman CH, Everitt MD, Kfoury AG, Stehlik J. Impact of donor left ventricular hypertrophy on survival after heart transplant. Am J Transplant. 2011 Dec;11(12):2755-61. doi: 10.1111/j.1600-6143.2011.03744.x. Epub 2011 Sep 11.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
10 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Heart Transplantation, run by Stanford University at 10 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 10 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Donor left ventricular ejection fraction, troponin, BNP, EKG changes (arrhythmias, QT prolongation, repolarization abnormalities, LVH, Q waves) (time frame: 5 years). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02376387, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Oct 2021.