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Trifecta-Heart cfDNA-MMDx undersøgelse

1. oktober 2026 opdateret af: University of Alberta

Trifecta-Heart cfDNA-MMDX-undersøgelse: Sammenligning af DD-cfDNA-testen med MMDx Microarray Test og Central HLA Antibody Test

Demonstrate the relationship between DD-cfDNA levels and HLA antibodies in blood transplant recipient and the Molecular Microscope® (MMDx) Diagnostic System results in indication and protocol biopsies from heart transplants.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The current standard for assessment of rejection in heart transplants is an endomyocardial biopsy (EMB) interpreted by histology according to ISHLT guidelines. This has considerable error rates, many due to the high disagreement among pathologists in assessing lesions and diagnoses. To address the unmet need for precision and accuracy, the Alberta Transplant Applied Genomics Centre (ATAGC, University of Alberta) has developed a new diagnostic system - the Molecular Microscope® Diagnostic System (MMDx), which uses microarrays to define the global gene expression features of rejection and injury. Now a new screening test is being introduced: the monitoring of donor-derived cell-free DNA (DD-cfDNA) released in the blood by the heart during rejection. The Natera Inc DD-cfDNA Prospera® test is based on the massively multiplex polymerase chain reaction that targets 13,392 single nucleotide polymorphisms and targeted sequences are quantified by Next Generation Sequencing. The Prospera® test has been done on kidney transplant recipients and detected "active rejection" and differentiated it from borderline rejection and no rejection. However, Prospera® test was not examined (the DD-cfDNA results) in heart transplant recipients. DD-cf-DNA test for heart transplants must now be calibrated against MMDx that is based on global gene expression, the new standard for biopsy interpretation. The present study will calibrate centrally measured (Natera Inc) DD-cfDNA levels obtained at the time of an indication or protocol biopsy against the MMDx measurements of T cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR) and early and late tissue injury. The present study will compare DD-cfDNA and MMDx in 300 prospectively collected biopsies for clinical indications and protocol, and accompanying 600 blood samples, to calibrate the DD-cfDNA (Natera Inc.) levels against the MMDx biopsy diagnoses of TCMR, ABMR (and its stages), and acute (early) and chronic (late) injury, , as well as central assessment of HLA antibody (One Lambda) in 300 blood samples, interpreted centrally as donor specific antibody (DSA) based on the tissue typing results. Trifecta-Heart collected 718 biopsies, 709 cfDNA samples and 706 One Lambda samples so far. Due to a considerable interest from participation centers, this study aims to collect 300 more biopsies and corresponding blood samples. This study is an extension of the INTERHEART ClinicalTrials.gov Identifier: NCT02670408

Undersøgelsestype

Observationel

Tilmelding (Anslået)

300

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Darlinghurst, Australien, NSW 2010
        • Ikke rekrutterer endnu
        • Cardiac Transplantation Laboratory, The Victor Chang Cardiac Research Institute
        • Ledende efterforsker:
          • Peter MacDonald, MD
        • Kontakt:
    • Alberta
      • Edmonton, Alberta, Canada, T6G 2R7
        • Rekruttering
        • Division of Cardiology, University of Alberta
        • Ledende efterforsker:
          • Daniel Kim, MD
        • Kontakt:
    • Arkansas
      • Little Rock, Arkansas, Forenede Stater, 72205
        • Rekruttering
        • Baptist Health Institute for Research and Innovation
        • Ledende efterforsker:
          • Patrick Campbell, MD
        • Kontakt:
    • Florida
      • Tampa, Florida, Forenede Stater, 33606
        • Rekruttering
        • Tampa General Hospital, 409 Bayshore Blvd.
        • Kontakt:
        • Ledende efterforsker:
          • Benjamin Mackie, MD
    • New Jersey
      • West New York, New Jersey, Forenede Stater, 10032
        • Rekruttering
        • Columbia University Medical Center, Columbia Interventional Cardiovascular Care
        • Ledende efterforsker:
          • Gabriel Sayer, MD
        • Kontakt:
    • New York
      • The Bronx, New York, Forenede Stater, 10467
    • Texas
      • Dallas, Texas, Forenede Stater, 75246
        • Rekruttering
        • Annette C. and Harold C. Simmons Transplant Institute, BaylorScott&White Research Institute
        • Kontakt:
        • Ledende efterforsker:
          • Shelley Hall, MD
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84132
        • Rekruttering
        • Cardiovascular Medicine, University of Utah Health
        • Kontakt:
        • Ledende efterforsker:
          • Josef Stehlik, MD, PhD
      • Bologna, Italien, 40138
        • Ikke rekrutterer endnu
        • Heart Failure and Heart Transplant Unit, University of Bologna
        • Ledende efterforsker:
          • Luciano Potena, MD
        • Kontakt:
      • Zabrze, Polen, 41-800
        • Rekruttering
        • Silesian Center for Heart Diseases (Ś!ąskie Centrum Chorób Serca w Zabrzu
        • Ledende efterforsker:
          • Piotr Przybylowski, Professor
        • Kontakt:
      • A Coruña, Spanien
        • Ikke rekrutterer endnu
        • Advanced Heart Failure Transplant Unit
        • Ledende efterforsker:
          • Maria G Crespo-Leiro, MD
        • Kontakt:
      • Prague, Tjekkiet, 140 21
        • Rekruttering
        • Institute for Clinical and Experimental Medicine - IKEM Videnska 1958/9
        • Kontakt:
        • Ledende efterforsker:
          • Vojtech Melenovsky, MD PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

The study population includes patients with a functioning heart transplant undergoing a biopsy for clinical indications or surveillance (protocol) biopsy.

Beskrivelse

Inclusion Criteria:

  • All heart transplant recipients undergoing a biopsy for clinical indications and protocol biopsies, as determined by their physician or surgeon, will be eligible to enroll in the study.
  • Patients are enrolled based on standard of care biopsies, including surveillance biopsies in high-risk patients, with informed consent.

Exclusion Criteria:

  • Patients will be excluded from the study if they decline participation
  • Are unable to give informed consent.
  • Recipients of multiple organs.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Heart transplant protocol and for cause biopsies

The study population includes patients with a functioning heart transplant undergoing a biopsy for clinical indications as standard of care, or protocol biopsies of heart in high-risk patients, or follow-up after treatment.

Microarray test of gene expression in heart biopsies

Donor derived cell-free DNA in patient blood

Centralized measurement of HLA antibodies in patient blood

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Calibration of Prospera test for T cell-mediated rejection
Tidsramme: 18 months

Set DD-cfDNA test cut-off values against the probability of T cell-mediated rejection in the biopsy as reported by MMDx. Calibration of DD-cfDNA test cut-off values against the probability of T cell-mediated rejection in the biopsy as reported by MMDx.

18 months
Calibration of Prospera test for antibody-mediated rejection
Tidsramme: 18 months

Set DD-cfDNA test cut-off values against the probability of antibody-mediated rejection in the biopsy as reported by MMDx.

18 months
Calibration of Prospera test for heart injury
Tidsramme: 18 month

Set DD-cfDNA test cut-off values against the probability of acute and chronic heart injury in the biopsy as reported by MMDx.

18 month
Report calibrated Prospera test results for rejection
Tidsramme: 6 months

Obtain clinicians feedback

6 months
Report calibrated Prospera test results for heart injury
Tidsramme: 6 month

Obtain clinicians feedback

6 month

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Determine if Prospera blood test can replace heart biopsy test
Tidsramme: 6 month

Obtain clinicians feedback

6 month
Determine if Prospera blood test can replace follow up heart biopsy
Tidsramme: 6 month

Determine whether resolution of DD-cfDNA after treatment can monitor response to therapy and avoid follow-up biopsies

6 month
Assessment of donor-specific antibody status
Tidsramme: 6 months

Report and compare the DSA status based on centralized and local HLA antibody measurement.

6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Philip F Halloran, MD PhD, Alberta Transplant Applied Genomics Center, University of Alberta

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. juni 2021

Primær færdiggørelse (Anslået)

1. december 2027

Studieafslutning (Anslået)

1. juli 2028

Datoer for studieregistrering

Først indsendt

11. januar 2021

Først indsendt, der opfyldte QC-kriterier

11. januar 2021

Først opslået (Faktiske)

13. januar 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • ATAGC06

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Only IPD data will be shared within a participating center.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .