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Liposomal Amphotericin B for Invasive Fungal Disease in Solid Organ Transplant Recipients (LAMB-SOT)

19. juni 2026 opdateret af: Lingai Pan, Sichuan Provincial People's Hospital

A Real-World Observational Study of the Effectiveness, Safety, and Therapeutic Drug Monitoring of Liposomal Amphotericin B in Solid Organ Transplant Recipients With Invasive Fungal Disease

This real-world observational study aims to evaluate the effectiveness, safety, and therapeutic drug monitoring (TDM) of liposomal amphotericin B (L-AmB) in solid organ transplant recipients with invasive fungal disease (IFD). IFD is a major cause of morbidity and mortality in transplant recipients because of long-term immunosuppressive therapy and increased susceptibility to opportunistic fungal infections.

This is a single-center ambispective cohort study conducted at Sichuan Provincial People's Hospital. The study includes a prospective cohort of solid organ transplant recipients receiving L-AmB therapy and a historical control cohort treated with alternative systemic antifungal regimens. Clinical management and treatment decisions will be determined by treating physicians according to routine clinical practice, and no study-specific intervention will be introduced.

The study will collect information on demographic characteristics, transplant type, immunosuppressive regimens, fungal pathogens, infection sites, antifungal treatment strategies, laboratory findings, and clinical outcomes. Particular attention will be given to renal safety, electrolyte abnormalities, and therapeutic drug monitoring of liposomal amphotericin B. Plasma concentrations of L-AmB, treatment modifications, temporary treatment discontinuation, and concentration-related safety and effectiveness outcomes will be recorded during antifungal therapy.

The primary outcomes are the 28-day clinical response rate and 84-day all-cause mortality. Secondary outcomes include mycological clearance, acute kidney injury, electrolyte abnormalities, breakthrough fungal infection, treatment discontinuation due to adverse events, liposomal amphotericin B plasma concentrations, and the associations between L-AmB exposure and clinical outcomes or treatment-related toxicities.

The study is expected to provide real-world evidence regarding the effectiveness, safety, and pharmacokinetic characteristics of L-AmB in transplant recipients, support optimization of antifungal treatment strategies, and inform individualized dosing and monitoring approaches in this high-risk population.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Anslået)

120

Kontakter og lokationer

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

Studiekontakt

Studiesteder

    • Sichuan
      • Chengdu, Sichuan, Kina, 610072
        • Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital
        • Kontakt:

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult solid organ transplant recipients diagnosed with proven, probable, or possible invasive fungal disease and treated with liposomal amphotericin B or alternative systemic antifungal therapy at Sichuan Provincial People's Hospital.

Beskrivelse

Inclusion Criteria:

  • Age 18 to 75 years.
  • Recipient of a solid organ transplant.
  • Diagnosis of invasive fungal disease (IFD) according to EORTC/MSGERC criteria.
  • Receiving liposomal amphotericin B therapy as part of routine clinical care.
  • Provision of informed consent for prospective participants.

Exclusion Criteria:

  • Known hypersensitivity to amphotericin B formulations.
  • Severe hepatic dysfunction (ALT or AST >5× upper limit of normal, or total bilirubin >2× upper limit of normal).
  • Severe renal dysfunction requiring permanent discontinuation of antifungal therapy at baseline.
  • Pregnancy or breastfeeding.
  • Participation judged inappropriate by the investigator.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Liposomal Amphotericin B Cohort
Solid organ transplant recipients with invasive fungal disease receiving liposomal amphotericin B therapy.
Liposomal amphotericin B administered for treatment of proven, probable, or possible invasive fungal disease in solid organ transplant recipients according to routine clinical practice. Dose adjustment and treatment duration are determined by treating physicians.
Andre navne:
  • L-AmB
Historical Control Cohort
Historical control patients with invasive fungal disease treated with alternative systemic antifungal regimens.
Alternative systemic antifungal agents including azoles, echinocandins, or other standard antifungal therapies administered according to routine clinical practice in historical control patients with invasive fungal disease.
Andre navne:
  • Azoles
  • Echinocandins

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
28-Day Clinical Response Rate
Tidsramme: Day 28
Proportion of participants achieving complete or partial clinical response at Day 28 after initiation of antifungal therapy.
Day 28
84-Day All-Cause Mortality
Tidsramme: Day 84
All-cause mortality occurring within 84 days after initiation of antifungal therapy.
Day 84

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Mycological Clearance Rate
Tidsramme: Day 28
Proportion of participants with documented clearance of fungal pathogens.
Day 28
Acute Kidney Injury
Tidsramme: Baseline through Day 84
Occurrence of acute kidney injury during antifungal treatment.
Baseline through Day 84
Electrolyte Abnormalities
Tidsramme: Baseline through Day 84
Occurrence of hypokalemia, hypomagnesemia, or other treatment-related electrolyte disturbances.
Baseline through Day 84
Breakthrough Fungal Infection
Tidsramme: Baseline through Day 84
Occurrence of breakthrough invasive fungal infection during antifungal therapy.
Baseline through Day 84
Antifungal Treatment Discontinuation Due to Adverse Events
Tidsramme: Baseline through Day 84
Permanent discontinuation of antifungal therapy because of treatment-related adverse events.
Baseline through Day 84
Liposomal Amphotericin B Plasma Concentration
Tidsramme: Baseline through Day 84
Plasma concentration of liposomal amphotericin B measured during antifungal therapy.
Baseline through Day 84
Association Between Liposomal Amphotericin B Exposure and Clinical Response
Tidsramme: Baseline through Day 84
Relationship between liposomal amphotericin B plasma concentration and clinical response.
Baseline through Day 84
Association Between Liposomal Amphotericin B Exposure and Adverse Events
Tidsramme: Baseline through Day 84
Relationship between liposomal amphotericin B plasma concentration and treatment-related adverse events, including nephrotoxicity and electrolyte abnormalities.
Baseline through Day 84

Samarbejdspartnere og efterforskere

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

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Lingai Pan, MD, Sichuan Provincial People's Hospital

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.

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 (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

30. marts 2028

Studieafslutning (Anslået)

30. juni 2028

Datoer for studieregistrering

Først indsendt

5. juni 2026

Først indsendt, der opfyldte QC-kriterier

14. juni 2026

Først opslået (Faktiske)

18. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • KC2025-JX-0390WLH-06 (Andet bevillings-/finansieringsnummer: Beijing Science and Technology Innovation Medical Development Foundation)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data will not be shared due to patient confidentiality and institutional data protection requirements.

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