- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05220787
Extended Cold Stored Apheresis Platelets in Cardiac Surgery Patients (CHASE)
July 26, 2023 updated by: Moritz Stolla, MD
Evaluation of Efficacy and Safety of Extended Cold Stored Apheresis Platelets Versus Conventional Apheresis Platelets in Cardiac Surgery Patients
This trial is being performed to evaluate the feasibility of the study protocol and to test the efficacy and safety of platelets stored at cold conditions (1-6°C) in 100% plasma for 10-14 days (CSP) in cardiac surgery patients who are actively bleeding and require platelet transfusion.
Study Overview
Status
Recruiting
Conditions
Detailed Description
Cardiac surgery featuring cardiopulmonary bypass (CPB) has a detrimental effect on platelet function.
Contact with foreign surfaces causes a transient platelet dysfunction.
The bleeding time is prolonged for the time on bypass and reverts to normal approximately one hour after cardiac surgery in uncomplicated cases.
Hemorrhage following cardiac surgery with CPB can cause surgical re-exploration and increased mortality.
The overall risk for surgical re-exploration is between 2.5-5%.
Patients who undergo re-exploration due to excessive bleeding have a 2-6 fold increased mortality compared with non-bleeding patients.
Storage of platelets at 1-6°C has the advantage of potentially prolonging storage times while reducing bacterial contamination.
Room-temperature storage has led to a 5 day storage time limit since bacterial growth and septic reactions increase rapidly after 5-7 days.
CSP were the standard of care in the 1960-70s.
CSP were abandoned when a reduced platelet survival was observed in platelet radiolabeling studies.
Nevertheless, CSP may have several advantages over RSP in the study population including a state of pre-activation and therefore a potentially superior hemostatic function.
A small pilot trial investigating CSP in cardiac surgery patients in Norway found a non-significant trend towards improved bleeding control with CSP transfusions.
However, data evaluating the in vivo efficacy of CSP is limited in scale and quality with mixed results.
The investigators and others have shown that CSP have a superior function compared with RSP in vitro and more data are needed to clarify the relative efficacy of CSP in vivo.
The investigators hypothesize that 1) CSP are more effective than RSP at reducing blood loss and improving platelet function in subjects actively bleeding due to cardiac surgery with cardiopulmonary bypass (CPB), and that 2) CSP are safe and do not lead to increased risks relative to RSP.
Study Type
Interventional
Enrollment (Estimated)
30
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Jeffrey Miles, M.S.
- Phone Number: 206-689-6285
- Email: jmiles@bloodworksnw.org
Study Contact Backup
- Name: Pat Klotz, BSN
- Phone Number: 206-568-2238
- Email: pklotz@bloodworksnw.org
Study Locations
-
-
Washington
-
Seattle, Washington, United States, 98122
- Recruiting
- Swedish Medical Center - Cherry Hill
-
Contact:
- Inger Rasmussen
- Phone Number: 206-215-3989
- Email: inger.rasmussen@swedish.org
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 100 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- 1. Subject age is greater than or equal to 18 years of age.
- 2. Subject can speak and read English.
- 3. Subject weight is greater than 40 kg.
- 4. Subject is scheduled for redo, triple valve, or complex aortic cardiac surgery with cardiopulmonary bypass.
- 5. Subject has ability to comprehend and willingness to sign Informed Consent Form (ICF).
- 6. If female of childbearing potential, must have a negative pregnancy test and agree to use one of the following methods of contraception during the course of study participation: abstinence, intrauterine contraception device, hormonal method, or barrier method.
- 7. Subject agrees to not participate in another interventional study during study participation.
- 8. The clinical site can obtain both possible platelet products (CSP and RSP) as needed per the study protocol given the subject's anticipated surgery date.
Exclusion Criteria:
- 1. Subject has history of known repeated, severe transfusion reactions.
- 2. Subject requires washed products, volume reduced products, or products with additive solution.
- 3. Subject is planned to receive autologous or directed transfusions.
- 4. Subject has or is expected to require post-surgical ventricular assist device (VAD), hemodialysis, or extracorporeal membrane oxygenation (ECMO) within 24 hours of the Study Treatment Window.
- 5. Subject is thrombocytopenic (less than 100 x 103 platelets/μL) on most recent measurement.
- 6. Subject is pregnant or breastfeeding.
- 7. Subject is a prisoner
- 8. Subject has active infection.
- 9. Subject refuses blood products.
- 10. Subject has a history of unprovoked deep vein thrombosis (DVT) or unprovoked pulmonary embolism (PE).
- 11. Subject has previously been enrolled and received a study platelet transfusion.
- 12. Subject has known bleeding diathesis (hemophilia, Von Willebrand Disease, or others)
- 13. At discretion of subject's physician, Sub-Investigator (SI), or Principle Investigator (PI).
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cold stored platelets in 100% plasma stored for 10-14 days
Cold stored apheresis platelets in 100% plasma stored for 10-14 days, maximum of up to three units (3x10^11/unit) from the start of surgery until 24 hours after the end of surgery
|
Subjects will receive cold stored platelets from the start of surgery until 24 hours after the end of surgery
|
Active Comparator: Room temperature stored platelets in 100% plasma stored for up to 7 days
Room temperature stored platelets in 100% plasma stored for up to 7 days, maximum of up to three units (3x10^11/unit) from the start of surgery until 24 hours after the end of surgery
|
Subjects will receive room temperature stored platelets from the start of surgery until 24 hours after the end of surgery
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of the recruitment and accrual into the study protocol.
Time Frame: 24 hours following end of cardiac surgery
|
Number of subjects screened and enrolled into the study protocol.
|
24 hours following end of cardiac surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Total allogeneic blood units transfused (RBCs only, platelets only, plasma only, and composite of all three)
Time Frame: Start of surgery to 24 hours after surgery
|
Number of units
|
Start of surgery to 24 hours after surgery
|
Chest tube output volume
Time Frame: 24 hours after completion of surgery
|
volume of chest tube output measured in milliliters.
|
24 hours after completion of surgery
|
Hemostatic agents administered
Time Frame: 24 hours after completion of surgery
|
The total individual doses of hemostatic agents
|
24 hours after completion of surgery
|
Number of subjects requiring surgical re-exploration due to uncontrolled bleeding
Time Frame: 24 hours after completion of surgery
|
binary
|
24 hours after completion of surgery
|
Number of subjects with evidence of new infection or sepsis
Time Frame: Through post-op day 3
|
per protocol definition
|
Through post-op day 3
|
Number of subjects with evidence of a thrombotic event
Time Frame: Through study completion, an average of 3 weeks.
|
per protocol definition
|
Through study completion, an average of 3 weeks.
|
Number of subjects with evidence of liver injury.
Time Frame: Through post-op day 3
|
Maximum post-operative change from pre-surgical baseline within the first three days
|
Through post-op day 3
|
Hospital free days
Time Frame: Post-op through day 28.
|
Number of days out of the hospital.
|
Post-op through day 28.
|
ICU free days
Time Frame: Post-op through day 28.
|
Number of days out of the ICU
|
Post-op through day 28.
|
Ventilator free days
Time Frame: post-op through day 28.
|
Number of days not on a ventilator.
|
post-op through day 28.
|
Mortality
Time Frame: Post-op through day 28.
|
To evaluate mortality at 28 days.
|
Post-op through day 28.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Moritz Stolla, MD, Bloodworks Northwest
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 21, 2022
Primary Completion (Estimated)
October 29, 2024
Study Completion (Estimated)
October 29, 2024
Study Registration Dates
First Submitted
October 11, 2021
First Submitted That Met QC Criteria
January 21, 2022
First Posted (Actual)
February 2, 2022
Study Record Updates
Last Update Posted (Actual)
July 27, 2023
Last Update Submitted That Met QC Criteria
July 26, 2023
Last Verified
July 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2021-01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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