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Muscle Function After Lung Transplantation in Patients With Chronic Obstructive Pulmonary Disease (COPD)

Conditions
COPD
Interventions
Other: Lung transplantation
Registration Number
NCT03548857
Lead Sponsor
Rigshospitalet, Denmark
Brief Summary

The purpose of the project is to investigate changes in the quadriceps muscle and cardiovascular regulation during exercise in relation to improved lung function after lung transplantation in patients with COPD.

Detailed Description

Dysfunctional skeletal musculature of the lower limbs is related to low quality of life, exercise intolerance and higher mortality in patients with COPD. Limb muscle dysfunction in COPD consists of muscle atrophy and reduced muscle strength but also intra-muscular alterations in oxidative capacity and mitochondrial function are often present. Moreover, reduced blood flow to exercising muscle may also contribute to the muscle dysfunction in COPD. The mechanisms responsible for muscle dysfunction in COPD patients remain unclear but could be a consequence of reduced lung function, inflammation, medications or low physical activity. Loss of lung function with COPD is normally irreversible so the transition to near-normal lung function after lung transplantation is a unique model to investigate the adaptation of the limb muscle to improved lung function. Thus, the purpose of this project is to investigate the effect of lung transplantation on limb muscle function (mitochondrial function, oxidative enzyme capacity, fiber type distribution, oxygen delivery/uptake) and daily physical activity level in patients with COPD. The project has a translational focus on muscle dysfunction in COPD and uses methodologies from clinical medicine, integrative physiology and molecular biochemistry in order to gain knowledge of mechanisms behind limb muscle dysfunction and exercise intolerance in COPD.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  • COPD with or without alpha 1-antitrypsin deficiency on the waiting list for a lung transplantation
  • Single or double lung transplantation
  • ≥ 18 years
  • Ability to give informed consent
Exclusion Criteria
  • Retransplantation
  • Multiple-organ transplantation (heart-lung transplantation)
  • Musculoskeletal disorders which substantially inhibits physical activity
  • Need for crossmatching in connection with lung transplantation
  • Anticoagulant therapy before lung transplantation (except acetylsalicylic acid)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
COPD patientsLung transplantationCOPD patients on the waiting list for a lung transplantation
Primary Outcome Measures
NameTimeMethod
Change in leg blood flow (mL/min)Change from baseline at 6 months

Endothelium function will be evaluated during acute exercise (one legged kicking) by Flow doppler

Change in 6 min walking testChange from baseline at 6 months

Exercise capacity

Change in health-related quality of lifeChange from baseline at 6 months

Health-related quality of life will be assessed by mean score of a validated Danish version of the COPD Assessment Test (CAT). The CAT is a short 8-item questionnaire with scoring range of 0-40, where higher scores indicating more limitations. A change of 2 units suggests a meaningful difference.

Secondary Outcome Measures
NameTimeMethod
Change in skeletal muscle functionChange from baseline at 6 months

Muscle biopsy

Change in capillarization of lung tissueChange from baseline at 6 months

Transbronchial biopsy (only COPD patients)

Change in blood volumeChange from baseline at 6 months

CO re-breathing method

Trial Locations

Locations (1)

the Centre for Physical Activity Research, Copenhagen University Hospital

🇩🇰

Copenhagen, Denmark

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