Bridge to Lung Transplant With Trans-septal Extra-corporeal Membrane Oxygenation (ECMO) for Right Heart Failure From Pulmonary Hypertension
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Protek Solo Transseptal Cannula.
- Who it may be relevant to
- Registry conditions: Lung Transplant, Pulmonary Hypertension. Basic parameters: 18 years — 80 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
A Pilot Study of Transseptal ECMO With the Protek Solo Cannula in Lung Transplant Candidates With Right Heart Failure From Pulmonary Hypertension
Overview
The purpose of this study is to determine if transseptal extra-corporeal membrane oxygenation (ECMO) can bridge pulmonary hypertension- right heart failure (PH-RVF) patients to lung transplant safely.
Detailed description
Results will be released as a manuscript once it has gone through the peer review process. Results will be released even in the event of negative outcomes and the release will be hastened if the study is terminated early.
Medicare beneficiaries may be affected by the device under investigation if they are candidates for lung transplant. Since this is such a select group of patients, we do not expect the results of this trial to be generalizable to the general Medicare population.
Interventions
- Device Protek Solo Transseptal Cannula
The Protek Solo Transseptal Cannula ECMO cannula will be placed from the right femoral vein and the drainage cannula will be placed from either the left femoral vein or the right internal jugular vein.
Primary outcome measures
- Survival until transplant [Time frame: 3 weeks]
Secondary outcome measures (4)
- Number of subjects to experience adverse events [Time frame: 2 months]
- Extra-corporeal membrane oxygenation (ECMO) support [Time frame: 2 months]
- Dialysis [Time frame: 2 months]
- Hospital Discharge [Time frame: 2 months]
Eligibility criteria
Inclusion criteria
Patients that are listed for lung transplantation and have:
- PH defined as:
- Group 1 Pulmonary arterial hypertension (PAH): Mean pulmonary artery pressure (PAP) ≥ 20 mm Hg, pulmonary capillary wedge pressure (PCWP) < 15 mm Hg, and pulmonary vascular resistance (PVR) ≥ 3 Wood units
- Group 3 PH is defined as the presence of chronic lung disease (CLD) and/or hypoxia and mean pulmonary artery pressure (PAP) ≥ 20 mm Hg.
- Secondary PH (WHO Group 3) or diagnosis of primary PH (WHO Group 1) (to include Eisenmenger syndrome).
- Failing right ventricle function defined as:
- a cardiac (CI) index < 2.2 L/min/m\^2 despite continuous infusion of high dose inotropes defined as:
- Inhaled nitric oxide > 20 ppm and one of the following:
- Dobutamine > 10 ug/kg/min x 15 minutes or
- Milrinone > 0.5 ug/kg/min x 120 minutes or
- Epinephrine > 0.5 ug/kg/min x 15 minutes or
- Norepinephrine > 0.5 ug/kg/min x 15 minutes and have one of the following:
- central venous pressure (CVP) > 15 mm Hg
- global RV dysfunction on echocardiography defined as one of the following:
- a tricuspid annular plane systolic excursion score of <14mm
- an RV diameter at base >42mm
- RV short-axis or midcavity diameter >35mm
- Lactate greater than 3 mmol/L
- Urine output < 0.5 ml/kg/hour
- Age > 18 years old
- BMI <35
- Informed consent signed by self or legally authorized representative.
Exclusion criteria
- INTERMACS 1 patients (Critical cardiogenic shock patient who is "crashing and burning", has life-threatening hypotension and rapidly escalating inotropic or pressor support, with critical organ hypoperfusion often confirmed by worsening acidosis and lactate levels)
- End organ failure defined as: hepatic total bilirubin >5 mg/dL based on lab data within 24 hours prior to transseptal ECMO initiation; renal creatinine >4 mg/dLbased on lab data within the 24 hours prior to transseptal ECMO initiation
- Evidence of acute neurologic injury
- Active infection defined as two of the following WBC >12,500, positive blood culture, fever
- RA thrombus
- Thrombolysis within the previous 30 days or known existing coagulopathy such as thrombocytopenia or hemoglobin diseases such as sickle cell anemia or thalassemia
- Right heart failure from isolated pulmonary embolism
- Right heart failure from coronary artery disease or from left heart failure (WHO Type 2)
- Congenital forms of pulmonary hypertension such as tetralogy of fallot or pulmonary vein stenosis.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
United States · 1 center
- Mayo Clinic in Florida — Jacksonville
Identifiers
NCT: NCT06770023 · 24-000660