Cardiac Transplantation Clinical Trial
Official title:
The Relationships Between Mycophenolic Acid Levels, T-Cell Subsets and Outcomes in Pediatric Heat Transplant Recipients Receiving Mycophenolate Mofetil (Cellcept)
The survival of children who have received heart transplants has greatly improved over the
last ten years. One reason for this is better control over rejection. Rejection medications
require a delicate balance of enough medicine to work without causing side effects. It is a
goal to avoid both rejection and side effects from the anti-rejection medicines. Usually
several medicines are used together to prevent rejection. One of these medicines is often
Mycophenolic Acid or CellceptThis medicine has been used longer for adults than is has for
children. More information is needed on using it for children. The dose is usually
determined by the patient's weight or body surface area.
There have been some early studies of the use of Cellcept, but none have proven a
relationship between the blood level of the drug and how well it works. More also needs to
be known about how this drug works with other anti-rejection drugs and how it works in boys
and girls. This study will look more closely at proper dosing, how Cellcept works with other
anti-rejection medications, side effects, and any differences in how this medicine works in
boys and girls.
All patients in the study will be receiving Cellcept and have blood levels of the drug
drawn. Results of their usual treatment and testing will be recorded and evaluated for signs
of rejection. All the information will be analyzed. Results of this study will be reported
to transplant committees locally and nationally.
Pediatric heart transplant recipients receiving MMF will undergo study testing to measure
MPA levels by the HPLC method and T-cell subsets by flow cytometry method. As standard of
care they receive histological grading of routine endomyocardial biopsies using the
International Society of Heart Lung Transplantation (ISHLT) grading scale. The data obtained
from standard assessments will include medications, echocardiographic reports, pre-and post
biopsy assessments/physical exams, hospital records for any inpatient hospitalization, and
any laboratory assessments. Also, information will be collected on all patients which will
be examined for tolerance and success (side effects and rejection) of immunosuppressive
therapy.
In newly transplanted patients, study testing will occur at the same time as standard of
care biopsies which are typically 1 week, 2 weeks, 3 weeks, 4 weeks, 6 weeks, 8 weeks, 3
months, 4 months, 5 months, 6 months, 8 months, 10 months, 12 months. If the patient has
additional visits due to rejection or changes in immunosuppression, then more frequent study
testing may be done per investigator preference. Previously transplanted patients will have
study testing at the same time as their standard of care visits, usually annually.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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