ALAMO is a prospective, multi-center, perspective, registry of patients receiving LungCare™ (AlloSure®-Lung, AlloMap Lung, and HistoMap) for surveillance post-transplant. This study aims to evaluate the diagnostic performance characteristics of AlloSure Lung (dd-cfDNA) to detect a spectrum of rejection (ACR, AMR) and allograft infection (Bacterial, Viral, Fungal, Mycobacterial, Parasitic).
This is a prospective, multicenter, observational registry of lung transplant recipients receiving LungCare (AlloSure-Lung, AlloMap Lung, and Histomap) surveillance testing. Patients will be recruited based on utilization of surveillance testing with LungCare, as deemed appropriate for their care post-transplant. Patients deemed eligible for the study by their physician will be invited to participate during their usual care visit. Enrolled patients will receive evaluations and treatment for their lung transplant according to their health care provider and clinical practice at each study site. Treatment and follow-up visits will be determined by the treating physician. Information related to surveillance testing, selected clinical outcomes, and treatments received for managing the lung transplant recipients will be collected from medical records. The product Laboratory Services Guide(s) will be provided as a reference. Patient data (including diagnosis and biopsy outcomes) will be drawn from the patients' medical records. This data will be recorded by the site study personnel via a web-based electronic data collection (EDC) system every month. The study is designed to observe the clinical use of LungCare and patient outcomes in a cohort of lung transplant recipients managed with LungCare. This cohort design is selected because it is efficient and effective to evaluate the real-world robust performance of LungCare on patient management and outcomes that can be generalized to the intended use population. A well-designed observational cohort study that includes a large number of patients with long-term follow-up may provide robust results with several advantages, such as gathering data regarding sequence of events to assess causality; examining multiple outcomes for a given LungCare use; calculating rates of biopsy and rejection; and operational efficiency.
Study Type
OBSERVATIONAL
Enrollment
550
University of Alabama (UAB)
Birmingham, Alabama, United States
ALAD
Diagnostic performance characteristics (sensitivity, specificity, PPV, NPV) of AlloSure Lung to detect acute lung allograft dysfunction (ALAD).
Time frame: 1 year post-transplant
Chronic lung allograft dysfunction
Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect chronic lung allograft dysfunction.
Time frame: 3 years post-transplant
Acute cellular rejection
Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect acute cellular rejection (ACR).
Time frame: 3 years post-transplant
Antibody mediated rejection
Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect antibody mediated rejection (AMR).
Time frame: 3 years post-transplant
Acute infection
Clinical diagnostic performance characteristics (sensitivity, specificity, PPV and NPV) of AlloSure Lung to detect acute infection.
Time frame: 3 years post-transplant
Subject Variability
Define within-subject and between-subject variability of AlloSure Lung in clinically stable patients in order to establish reference change value RCV.
Time frame: 3 years post-transplant
ALAD vs. Stability
Evaluate the diagnostic performance characteristics of utilizing RCV to distinguish ALAD vs. Stability
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St. Joseph's Hospital & Medical Center
Phoenix, Arizona, United States
Cedars Sinai Medical Center
Los Angeles, California, United States
University of California (UCSF) School of Medicine
San Francisco, California, United States
University of CO Anschutz Medical Campus
Aurora, Colorado, United States
AdventHealth Orlando
Orlando, Florida, United States
Loyola University Medical School
Maywood, Illinois, United States
University of Louisville Health
Louisville, Kentucky, United States
University of Mayland
Baltimore, Maryland, United States
Brigham and Womens Hospital
Boston, Massachusetts, United States
...and 12 more locations
Time frame: 3 years post-transplant
Biopsy-proven rejections
The proportion of biopsy-proven rejections with elevated AlloSure Lung versus those without elevated AlloSure-Lung.
Time frame: 3 years post-transplant
AlloSure Lung Results
The proportion of AlloSure Lung results obtained as surveillance or for-cause, that the physicians felt influenced their decisions around management of patients.
Time frame: 3 years post-transplant
ALAD Free survival
ALAD free survival in lung transplant recipients who received AlloSure Lung as part of post-transplant surveillance.
Time frame: 3 years post-transplant
AlloSure Levels
Evaluate AlloSure levels 30-90 days prior to acute rejection.
Time frame: 3 years post-transplant