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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01429844
Registration number
NCT01429844
Ethics application status
Date submitted
5/09/2011
Date registered
7/09/2011
Date last updated
7/09/2011
Titles & IDs
Public title
Tacrolimus Versus Cyclosporine for Immunosuppression After Lung Transplantation
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Scientific title
Randomized, Open-label, Multi-Center Study Comparing Tacrolimus With Cyclosporin, Both Arms in Combination With Mycophenolate Mofetil and Corticosteroids for Prevention of Bronchiolitis Obliterans Syndrome in Lung Transplant Patients
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Secondary ID [1]
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EAILTx Tac vs. CsA in LuTx
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Universal Trial Number (UTN)
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Trial acronym
EAILTX
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Bronchiolitis Obliterans
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Immunosuppression
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Condition category
Condition code
Respiratory
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Other respiratory disorders / diseases
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Inflammatory and Immune System
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Other inflammatory or immune system disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Tacrolimus
Treatment: Drugs - Cyclosporine
Active comparator: Tacrolimus - Tacrolimus in combination with mycophenolate mofetil and steroids for denovo immunosuppression after lung transplantation
Active comparator: Cyclosporine - Cyclopsorine in combination with mycophenolate mofetil and steroids for denovo immunosuppression after lung transplantation
Treatment: Drugs: Tacrolimus
Tacrolimus therapy was started immediately after transplantation with a continuous intravenous infusion of 0.01-0.03 mg/kg/d. After extubation, the mode of delivery was switched to oral administration (b.i.d.) with doses of 0.05-0.3 mg/kg/d. Tacrolimus doses were adjusted to trough levels. Target C0 (trough) levels were 10-15 ng/ml for the first 3 months after transplantation and 8-12 ng/ml thereafter with dose adjustments according to patient outcome.
Treatment: Drugs: Cyclosporine
Cyclosporine therapy was started immediately after transplantation with a continuous intravenous infusion of 1-3 mg/kg/d. After extubation the mode of delivery was switched to oral administration (b.i.d. or t.i.d.) with doses of 4-18 mg/kg/d. Cyclosporine doses were adjusted to C0 or C2 levels according to local practice. Target trough levels were 200 - 300 ng/ml for the first 3 months after transplantation and 150 - 200 ng/ml thereafter.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Incidence of bronchiolitis obliterans syndrome
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Assessment method [1]
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The incidence of patients with bronchiolitis obliterans syndrome (BOS), defined as a sustained fall (for \>1 month) in maximum FEV1 of 20% or more (compared to baseline) over three years post transplant.
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Timepoint [1]
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3 years post transplant
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Secondary outcome [1]
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Acute allograft rejection
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Assessment method [1]
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One- and 3-year rates of acute allograft rejection determined by clinical criteria or transbronchial lung biopsy.
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Timepoint [1]
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3 years post transplant
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Secondary outcome [2]
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Patient and graft survival
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Assessment method [2]
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Patient and graft survival at one and three years
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Timepoint [2]
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3 years post transplant
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Secondary outcome [3]
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Incidence and spectrum of infections
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Assessment method [3]
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Incidence and spectrum (viral, bacterial, fungal)of infections after transplantation
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Timepoint [3]
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3 years post transplant
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Secondary outcome [4]
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Renal failure
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Assessment method [4]
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Post operative onset of renal dysfunction (defined as a persistent increase in serum creatinine of \> 2mg/dl) or dialysis dependency
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Timepoint [4]
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3 years post transplant
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Secondary outcome [5]
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Treatment failure
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Assessment method [5]
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Treatment failure defined as drug discontinuation (e.g. conversion to a different immunosuppression regimen)
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Timepoint [5]
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3 years post transplant
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Eligibility
Key inclusion criteria
* male or female recipients of a first heart-lung
* bilateral or single lung allograft suitable to receive triple immunosuppressive therapy with tacrolimus or cyclosporine, MMF and corticosteroids per standard guidelines
* Age range = 18-66 years
* Able to understand the purposes and risks of the study
* Female patients of child bearing age agreeing to maintain effective birth control practice during the follow-up period
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Minimum age
18
Years
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Maximum age
66
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* need for immunosuppressive regimen other than study medication or received additional organ transplantations
* Pregnant women, nursing mothers or women unwilling to use adequate contraception
* Serologic evidence of human immunodeficiency virus, hepatitis B surface antigen or hepatitis C virus antibodies
* Panresistant infections with Burkholderia cepacia or mycobacteria during the last 12 months preceding lung transplantation
* Patients with renal insufficiency (creatinine clearance < 40 ml/min
* Patients in need of invasive ventilator devices or extracorporeal membrane oxygenation
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/01/2001
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/08/2010
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Sample size
Target
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Accrual to date
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Final
274
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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St. Vincent's Hospital - Sydney
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Recruitment postcode(s) [1]
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NSW 2010 - Sydney
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Recruitment outside Australia
Country [1]
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Austria
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State/province [1]
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Wien
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Country [2]
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Belgium
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State/province [2]
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Bruxelles
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Belgium
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State/province [3]
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Leuven
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Germany
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State/province [4]
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Essen
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Country [5]
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Germany
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State/province [5]
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Hamburg
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Country [6]
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Germany
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State/province [6]
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Jena
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Country [7]
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Germany
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Kiel
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Country [8]
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Spain
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State/province [8]
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Barcelona
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Country [9]
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Spain
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State/province [9]
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Cordoba
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Country [10]
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Spain
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State/province [10]
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La Coruna
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Country [11]
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Spain
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Madrid
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Country [12]
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Spain
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State/province [12]
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Santander
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Country [13]
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Switzerland
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State/province [13]
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Lausanne
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Funding & Sponsors
Primary sponsor type
Other
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Name
Universitätsklinikum Hamburg-Eppendorf
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of the study is to compare efficacy and safety of two different immunosuppressive regimens for prevention of bronchiolitis obliterans syndrome (BOS) (chronic lung allograft rejection)after lung transplantation: tacrolimus versus cyclosporine, both in combination with mycophenolate mofetil and steroids. The study was powered to detect a 15% reduction in BOS in tacrolimus treated patients. Study design: open-label, randomized, comparative, multi-center, investigator driven
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Trial website
https://clinicaltrials.gov/study/NCT01429844
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Trial related presentations / publications
Aurora P, Edwards LB, Kucheryavaya AY, Christie JD, Dobbels F, Kirk R, Rahmel AO, Stehlik J, Hertz MI. The Registry of the International Society for Heart and Lung Transplantation: thirteenth official pediatric lung and heart-lung transplantation report--2010. J Heart Lung Transplant. 2010 Oct;29(10):1129-41. doi: 10.1016/j.healun.2010.08.008. No abstract available. Reichenspurner H, Girgis RE, Robbins RC, Conte JV, Nair RV, Valentine V, Berry GJ, Morris RE, Theodore J, Reitz BA. Obliterative bronchiolitis after lung and heart-lung transplantation. Ann Thorac Surg. 1995 Dec;60(6):1845-53. doi: 10.1016/0003-4975(95)00776-8. Snell GI, Boehler A, Glanville AR, McNeil K, Scott JP, Studer SM, Wallwork J, Westall G, Zamora MR, Stewart S. Eleven years on: a clinical update of key areas of the 1996 lung allograft rejection working formulation. J Heart Lung Transplant. 2007 May;26(5):423-30. doi: 10.1016/j.healun.2007.01.040. No abstract available. Estenne M, Maurer JR, Boehler A, Egan JJ, Frost A, Hertz M, Mallory GB, Snell GI, Yousem S. Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria. J Heart Lung Transplant. 2002 Mar;21(3):297-310. doi: 10.1016/s1053-2498(02)00398-4. No abstract available. Hachem RR, Yusen RD, Chakinala MM, Meyers BF, Lynch JP, Aloush AA, Patterson GA, Trulock EP. A randomized controlled trial of tacrolimus versus cyclosporine after lung transplantation. J Heart Lung Transplant. 2007 Oct;26(10):1012-8. doi: 10.1016/j.healun.2007.07.027. Keenan RJ, Konishi H, Kawai A, Paradis IL, Nunley DR, Iacono AT, Hardesty RL, Weyant RJ, Griffith BP. Clinical trial of tacrolimus versus cyclosporine in lung transplantation. Ann Thorac Surg. 1995 Sep;60(3):580-4; discussion 584-5. doi: 10.1016/0003-4975(95)00407-C. Treede H, Klepetko W, Reichenspurner H, Zuckermann A, Meiser B, Birsan T, Wisser W, Reichert B; Munich and Vienna Lung Transplant Group. Tacrolimus versus cyclosporine after lung transplantation: a prospective, open, randomized two-center trial comparing two different immunosuppressive protocols. J Heart Lung Transplant. 2001 May;20(5):511-7. doi: 10.1016/s1053-2498(01)00244-3. Zuckermann A, Reichenspurner H, Birsan T, Treede H, Deviatko E, Reichart B, Klepetko W. Cyclosporine A versus tacrolimus in combination with mycophenolate mofetil and steroids as primary immunosuppression after lung transplantation: one-year results of a 2-center prospective randomized trial. J Thorac Cardiovasc Surg. 2003 Apr;125(4):891-900. doi: 10.1067/mtc.2003.71. Sarahrudi K, Estenne M, Corris P, Niedermayer J, Knoop C, Glanville A, Chaparro C, Verleden G, Gerbase MW, Venuta F, Bottcher H, Aubert JD, Levvey B, Reichenspurner H, Auterith A, Klepetko W. International experience with conversion from cyclosporine to tacrolimus for acute and chronic lung allograft rejection. J Thorac Cardiovasc Surg. 2004 Apr;127(4):1126-32. doi: 10.1016/j.jtcvs.2003.11.009. Vitulo P, Oggionni T, Cascina A, Arbustini E, D'Armini AM, Rinaldi M, Meloni F, Rossi A, Vigano M. Efficacy of tacrolimus rescue therapy in refractory acute rejection after lung transplantation. J Heart Lung Transplant. 2002 Apr;21(4):435-9. doi: 10.1016/s1053-2498(01)00379-5. McNeil K, Glanville AR, Wahlers T, Knoop C, Speich R, Mamelok RD, Maurer J, Ives J, Corris PA. Comparison of mycophenolate mofetil and azathioprine for prevention of bronchiolitis obliterans syndrome in de novo lung transplant recipients. Transplantation. 2006 Apr 15;81(7):998-1003. doi: 10.1097/01.tp.0000202755.33883.61. Orens JB, Estenne M, Arcasoy S, Conte JV, Corris P, Egan JJ, Egan T, Keshavjee S, Knoop C, Kotloff R, Martinez FJ, Nathan S, Palmer S, Patterson A, Singer L, Snell G, Studer S, Vachiery JL, Glanville AR; Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. International guidelines for the selection of lung transplant candidates: 2006 update--a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2006 Jul;25(7):745-55. doi: 10.1016/j.healun.2006.03.011. No abstract available. Shyu S, Dew MA, Pilewski JM, DeVito Dabbs AJ, Zaldonis DB, Studer SM, Crespo MM, Toyoda Y, Bermudez CA, McCurry KR. Five-year outcomes with alemtuzumab induction after lung transplantation. J Heart Lung Transplant. 2011 Jul;30(7):743-54. doi: 10.1016/j.healun.2011.01.714. Epub 2011 Mar 21.
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Public notes
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Contacts
Principal investigator
Name
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Hermann Reichenspurner, MD, PhD
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Address
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Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Contact person for public queries
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01429844
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