MedPath

AlloSure Lung Assessment and Metagenomics Outcomes Study

Recruiting
Conditions
Lung Transplant Infection
Lung Transplant Failure and Rejection
Lung Transplant; Complications
Registration Number
NCT05050955
Lead Sponsor
CareDx
Brief Summary

ALAMO is a prospective, multi-center, perspective, registry of patients receiving LungCare™ (AlloSure®-Lung, AlloMap Lung, and HistoMap) for surveillance post-transplant. This study aims to evaluate the diagnostic performance characteristics of AlloSure Lung (dd-cfDNA) to detect a spectrum of rejection (ACR, AMR) and allograft infection (Bacterial, Viral, Fungal, Mycobacterial, Parasitic).

Detailed Description

This is a prospective, multicenter, observational registry of lung transplant recipients receiving LungCare (AlloSure-Lung, AlloMap Lung, and Histomap) surveillance testing. Patients will be recruited based on utilization of surveillance testing with LungCare, as deemed appropriate for their care post-transplant. Patients deemed eligible for the study by their physician will be invited to participate during their usual care visit. Enrolled patients will receive evaluations and treatment for their lung transplant according to their health care provider and clinical practice at each study site. Treatment and follow-up visits will be determined by the treating physician. Information related to surveillance testing, selected clinical outcomes, and treatments received for managing the lung transplant recipients will be collected from medical records. The product Laboratory Services Guide(s) will be provided as a reference. Patient data (including diagnosis and biopsy outcomes) will be drawn from the patients' medical records. This data will be recorded by the site study personnel via a web-based electronic data collection (EDC) system every month.

The study is designed to observe the clinical use of LungCare and patient outcomes in a cohort of lung transplant recipients managed with LungCare. This cohort design is selected because it is efficient and effective to evaluate the real-world robust performance of LungCare on patient management and outcomes that can be generalized to the intended use population. A well-designed observational cohort study that includes a large number of patients with long-term follow-up may provide robust results with several advantages, such as gathering data regarding sequence of events to assess causality; examining multiple outcomes for a given LungCare use; calculating rates of biopsy and rejection; and operational efficiency.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
550
Inclusion Criteria
  1. Unilateral or Bilateral, deceased-donor, initial or re-transplant
  2. ≤ 90 days post-transplant
  3. Ability to understand and provide informed consent and adhere to laboratory surveillance schedule
  4. Patients who have LungCare initiated within 30 days of signing the informed consent form
Exclusion Criteria
  1. Multi-organ transplants
  2. Pregnancy
  3. Active malignancy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
ALAD1 year post-transplant

Diagnostic performance characteristics (sensitivity, specificity, PPV, NPV) of AlloSure Lung to detect acute lung allograft dysfunction (ALAD).

Secondary Outcome Measures
NameTimeMethod
Biopsy-proven rejections3 years post-transplant

The proportion of biopsy-proven rejections with elevated AlloSure Lung versus those without elevated AlloSure-Lung.

Acute cellular rejection3 years post-transplant

Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect acute cellular rejection (ACR).

ALAD vs. Stability3 years post-transplant

Evaluate the diagnostic performance characteristics of utilizing RCV to distinguish ALAD vs. Stability

Antibody mediated rejection3 years post-transplant

Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect antibody mediated rejection (AMR).

Subject Variability3 years post-transplant

Define within-subject and between-subject variability of AlloSure Lung in clinically stable patients in order to establish reference change value RCV.

AlloSure Lung Results3 years post-transplant

The proportion of AlloSure Lung results obtained as surveillance or for-cause, that the physicians felt influenced their decisions around management of patients.

Chronic lung allograft dysfunction3 years post-transplant

Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect chronic lung allograft dysfunction.

ALAD Free survival3 years post-transplant

ALAD free survival in lung transplant recipients who received AlloSure Lung as part of post-transplant surveillance.

AlloSure Levels3 years post-transplant

Evaluate AlloSure levels 30-90 days prior to acute rejection.

Acute infection3 years post-transplant

Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect acute infection.

Trial Locations

Locations (22)

University of Wisconsin Madison

🇺🇸

Madison, Wisconsin, United States

University of Alabama (UAB)

🇺🇸

Birmingham, Alabama, United States

St. Joseph's Hospital & Medical Center

🇺🇸

Phoenix, Arizona, United States

Cedars Sinai Medical Center

🇺🇸

Los Angeles, California, United States

University of California (UCSF) School of Medicine

🇺🇸

San Francisco, California, United States

University of CO Anschutz Medical Campus

🇺🇸

Aurora, Colorado, United States

AdventHealth Orlando

🇺🇸

Orlando, Florida, United States

Loyola University Medical School

🇺🇸

Maywood, Illinois, United States

University of Louisville Health

🇺🇸

Louisville, Kentucky, United States

University of Mayland

🇺🇸

Baltimore, Maryland, United States

Brigham and Womens Hospital

🇺🇸

Boston, Massachusetts, United States

Washington University-Barnes Jewish Hospital

🇺🇸

Saint Louis, Missouri, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

NYU Langone Health

🇺🇸

New York, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Ohio State University

🇺🇸

Columbus, Ohio, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Temple University

🇺🇸

Philadelphia, Pennsylvania, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

UT Health/ Memorial Hermann Hospital

🇺🇸

Houston, Texas, United States

Inova

🇺🇸

Falls Church, Virginia, United States

Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

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