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Trial registered on ANZCTR
Registration number
ACTRN12615001196538
Ethics application status
Approved
Date submitted
27/10/2015
Date registered
4/11/2015
Date last updated
1/11/2019
Date data sharing statement initially provided
27/11/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effect of the remote ischemic preconditioning on primary graft failure after heart transplantation: A Randomized Controlled Trial
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Scientific title
Effect of the remote ischemic preconditioning on primary graft failure after heart transplantation: A Randomized Controlled Trial
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Secondary ID [1]
287735
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
heart transplant rejection
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primary graft failure
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Condition category
Condition code
Surgery
296837
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0
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Other surgery
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Cardiovascular
296838
296838
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is the application of remote ischaemic preconditioning (RIPC) protocol to patients undergoing heart transplantation. The RIPC protocol will be instituted by four five-minute cycles of arm ischaemia with intervening five minutes of reperfusion following induction of standard anaesthesia in the operating room. Inflating a standard blood pressure cuff to a pressure exceeding systolic by 20 mmHg will interrupt blood flow. The cuff would be deflated during reperfusion. Blood flow interruption and restoration will be documented by a standard finger pulse oximetry, which will serve to monitor adherence. Control patients will have sham placement of cuff without inflation. For early effect, the preconditioning will be performed after the patient has been anaesthetised while routine central lines are being placed, prior to heart transplantation.
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Intervention code [1]
293133
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Treatment: Devices
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Comparator / control treatment
Control patients will have sham placement of cuff without inflation.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Proportion of participants with a reduction in post-transplant need for high-dose inotropes or circulatory support (this is a composite primary outcome). This will be assessed by review of hospital records.
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Assessment method [1]
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Timepoint [1]
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measured at 3h, 6h, 12h, 24h and 72h after heart transplant
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Primary outcome [2]
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Proportion of participants with a reduction in post-transplant LVEF (assessed via routine echocardiogram)
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Assessment method [2]
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Timepoint [2]
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measured at 24 hours, one week, one month, three months and six months after heart transplantation
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Primary outcome [3]
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Proportion of participants with a reduction in troponin I (assessed by blood testing)
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Assessment method [3]
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Timepoint [3]
296449
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measured at baseline, three, six, 12, 24 and 72 hours after heart transplantation
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Secondary outcome [1]
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Proportion of participants with a reduction in ICU stay (days) (assessed by review of hospital records)
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Assessment method [1]
318470
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Timepoint [1]
318470
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recorded at six months after surgery
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Secondary outcome [2]
318471
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Proportion of participants with a reduction in number of treated rejection episodes during the first six months after heart transplant (assessed by review of hospital records)
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Assessment method [2]
318471
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Timepoint [2]
318471
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recorded at six months after surgery
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Secondary outcome [3]
318472
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Proportion of participants with a reduction in hospital stay (days) (assessed by review of hospital records)
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Assessment method [3]
318472
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Timepoint [3]
318472
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recorded at six months after surgery
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Secondary outcome [4]
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Proportion of participants with a reduction in troponin T (assessed by blood testing) Note: this is a primary outcome.
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Assessment method [4]
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Timepoint [4]
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measured at baseline, three, six, 12, 24 and 72 hours after heart transplantation
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Eligibility
Key inclusion criteria
Adults and children aged >15 years undergoing heart transplantation for the first time.
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Minimum age
15
Years
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Maximum age
No limit
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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
Patients taking oral hypoglycaemic drugs (i.e., sulfonylurea derivatives, glyburide, or glibenclamide) will be excluded.
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Study design
Purpose of the study
Treatment
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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)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
3/09/2015
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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
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Sample size
Target
50
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Accrual to date
15
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
15084
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
28380
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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N/A
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Address [1]
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N/A
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Country [1]
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Primary sponsor type
Individual
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Name
Professor Igor E. Konstantinov
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Address
Royal Children’s Hospital
50 Flemington Road
Parkville VIC 3052
Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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RCH HREC
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Ethics committee address [1]
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Royal Children’s Hospital 50 Flemington Road Parkville VIC 3052 Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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17/10/2013
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Approval date [1]
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28/01/2014
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Ethics approval number [1]
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33224 B
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Summary
Brief summary
Objectives of this study are to assess the effects of the remote ischemic preconditioning (RIPC) on the primary graft failure (PGF), heart function and multi-organ protection after heart transplantation. This is a prospective, multi-centre, double-blind randomized controlled clinical trial (RCT). The outcome of the study is expected to determine if significant protection by the RIPC previously achieved in animal study can be translated into clinical heart transplantation. Study Duration: Three years. Intervention is the RIPC stimulus (also referred to as ‘protocol’) which consists of four five-minute cycles of arm ischemia with intervening five minutes of reperfusion following induction of standard anaesthesia in the operating room, prior to heart transplantation (HT). Inflating a standard blood pressure cuff to a pressure exceeding systolic by 20 mmHg will interrupt blood flow. The cuff would be deflated during reperfusion. Control patients will have sham placement of cuff without inflation. Participants will be monitored after HT and an analysis of blood samples (involving an examination of markers of myocardial damage, i.e., troponin I) collected as a part of standard care will be used to determine if there are protective effects due to the RIPC protocol used. Number of Subjects: 50. Population: Adults and children aged >15 years undergoing heart transplantation for the first time.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Igor E. Konstantinov
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Address
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Royal Children’s Hospital
50 Flemington Road
Parkville VIC 3052
Australia
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Country
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Australia
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Phone
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61 3 9345 5200
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Igor E. Konstantinov
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Address
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Royal Children’s Hospital
50 Flemington Road
Parkville VIC 3052
Australia
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Country
61179
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Australia
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Phone
61179
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61 3 9345 5200
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Igor E. Konstantinov
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Address
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Royal Children’s Hospital
50 Flemington Road
Parkville VIC 3052
Australia
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Country
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Australia
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Phone
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61 3 9345 5200
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Fax
61180
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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