Two-Layer Method Preservation and Resuscitation of the Cadaveric Pancreas Before Transplantation
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Purpose
The purpose of this project is to compare the effect of oxygenated preservation of the pancreas before transplantation using the "Two-Layer Method" (TLM) against outcomes previously experienced with organs preserved using only standard University of Wisconsin (UW) storage solution. It is our hypothesis that TLM preservation will reduce the frequency and severity of complications of pancreas transplantation, increase the number of organs acceptable for transplantation, and spare individual patients and their families suffering and hardship.
| Condition | Intervention | Phase |
|---|---|---|
|
Graft Pancreatitis |
Device: Two-Layer Method pancreas preservation system |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Two-Layer Method Preservation and Resuscitation of the Cadaveric Pancreas Before Transplantation |
- Post-transplantation adverse event frequency (graft thrombosis, hemorrhage, peri-pancreatic abscess, re-laparotomy, cadaver duodenum leak, pseudo-aneurysm formation, rejection, graft failure, patient death) [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
- Standard post-transplantation morbidity endpoints including fungal, bacterial, and viral infections, and incidence and rate of stroke and heart attack. Length of hospital stay and re-admission and re-operation rates will also be monitored. [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
| Enrollment: | 7 |
| Study Start Date: | October 2007 |
| Study Completion Date: | April 2009 |
| Primary Completion Date: | April 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Device: Two-Layer Method pancreas preservation system
Preserving the pancreas before transplantation in an oxygenated system containing highly oxygenated liquid perfluorocarbon (perfluorodecalin, C10F18. The perfluorocarbon combines low toxicity with a capacity to dissolve 75 times more oxygen than the UW solution used in standard pancreas storage. When preserved under these conditions, the pancreas absorbs oxygen by diffusion and steadily consumes it, supporting sufficient aerobic metabolism to maintain tissue ATP concentrations at near-physiologic levels and prevent, or even reverse, pancreas anoxic injury.
|
Detailed Description:
Two-Layer Method (TLM) preservation consists of a storage chamber containing a layer of highly oxygenated, water-immiscible liquid perfluorocarbon (perfluorodecalin, C10F18) surmounted by a layer of conventional UW (or similar) organ preservation solution. The perfluorocarbon is sufficiently dense (~2 g/ml) that the pancreas floats on top of it, in contact with both layers. The perfluorocarbon combines low toxicity with an oxygen content 75 times greater than the UW solution used in standard pancreas storage. When preserved under these conditions, the pancreas absorbs oxygen by diffusion and steadily consumes it, supporting sufficient aerobic metabolism to maintain tissue ATP concentrations at near-physiologic levels and prevent, or even reverse, pancreas anoxic injury. In animal models of pancreas ischemic and storage injury, TLM preservation has been strikingly successful at improving the outcome of both islet isolation and pancreas transplantation.
Eligibility| Ages Eligible for Study: | 19 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Listed for pancreas transplantation at the University of Nebraska Medical Center
Exclusion Criteria:
- Ineligibility for medical/surgical/psychosocial reasons for listing for pancreas transplantation at the University of Nebraska Medical Center.
Contacts and Locations| United States, Nebraska | |
| The Nebraska Medical Center | |
| Omaha, Nebraska, United States, 68198 | |
| Principal Investigator: | R Brian Stevens, MD, PhD | University of Nebraska |
More Information
Publications:
| Responsible Party: | R. Brian Stevens, MD, PhD Director Kidney and Pancreas Transplantation Program, University of Nebraska Medical Center, Department of Surgery |
| ClinicalTrials.gov Identifier: | NCT00592280 History of Changes |
| Other Study ID Numbers: | 047-07-FB, IDE G060082 |
| Study First Received: | December 17, 2007 |
| Last Updated: | April 16, 2010 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Nebraska:
|
Pancreas transplantation graft pancreatitis Two-layer method organ preservation |
Additional relevant MeSH terms:
|
Pancreatitis Pancreatitis, Graft Pancreatic Diseases Digestive System Diseases Pancreatin |
Pancrelipase Gastrointestinal Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013