CATCH: Creating Access to Transplant for Candidates who are High Risk

CATCH：为高风险候选人创造移植机会

• 批准号: 10677626
• 负责人: Meghan M Aversa
• 金额: $ 39.87万
• 依托单位: UNIVERSITY HEALTH NETWORK
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-05 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677626
• 关键词: Acute Respiratory Distress Syndrome; Address; Affect; Age; Body mass index; Boston; COVID-19; COVID-19/ARDS; Caring; Categories; Cells; Clinical; Collaborations; Complement; Consensus; Critical Illness; Data; Disadvantaged; Disparity; Donor person; Eligibility Determination; Ensure; Exercise; Extracorporeal Membrane Oxygenation; Florida; Future; Goals; Guidelines; Health; Hospitals; Immunosuppression; Improve Access; Individual; International; Leadership; Length of Stay; Life; Lung; Lung Transplantation; Lung diseases; Mechanical ventilation; Mechanics; New York; Operative Surgical Procedures; Outcome; Patient Participation; Patient-Focused Outcomes; Patients; Perioperative; Physical therapy; Positioning Attribute; Predictive Factor; Procedures; Process; Prospective, cohort study; Protocols documentation; Pulmonology; Quality of life; Regimen; Research; Risk; Sedation procedure; Selection Criteria; Site; Standardization; Thoracic Surgical Procedures; Time; Transplant Recipients; Transplantation; Uncertainty; United States National Institutes of Health; Universities; Variant; Waiting Lists; Walking; Woman; access disparities; antibody-mediated rejection; candidate selection; desensitization; donor-specific antibody; experience; graft dysfunction; health related quality of life; high risk; improved; improved outcome; mortality; multidisciplinary; organ allocation; post-transplant; programs; transplant centers; virtual; willingness

PROJECT SUMMARY Today, lung transplantation for patients with end-stage lung disease has become increasingly standardized around the world, thanks to decades of international collaboration and partnership. As a result, more patients can receive a life-saving procedure and benefit from vastly improved survival and quality of life. However, access to lung transplant remains particularly variable for three categories of high-risk patients: 1) highly sensitized patients; 2) patients requiring extracorporeal membrane oxygenation support as a bridge to transplant (ECMO-BTT); and 3) patients with acute respiratory distress syndrome (ARDS, including those with COVID-19-associated ARDS). Because these patients are at high-risk for complications and historically understudied, there are no clear guidelines for their treatment. As a result, they are uniquely disadvantaged: receiving a transplant largely depends on their program’s willingness to accept the risk of transplant without sufficient data to inform how it can be optimally and safely performed. Programs, therefore, differ in the selection and management of these patients, creating significant disparities and variation in care across centers, ultimately to the detriment of the transplant candidate. With support from the NIH Lung Transplant Consortium, we propose the formation of CATCH: Creating Access to Transplant for Candidates who are High Risk, with the goal to improve access and outcomes for these patients in need. The four lung transplant programs that comprise CATCH—University Health Network, University of Florida, Columbia University, and Brigham and Women’s Hospital—collectively perform over 400 lung transplantations per year, and each have extensive but differing experience in managing these patients. Our CATCH study hypothesis is that our individual management strategies significantly impact high-risk candidates’ likelihood of receiving a transplant and their post-transplant outcomes. Through prospective cohort studies, we aim to devise an optimal and united strategy that addresses the specific unmet needs of these high risk patients. Our team has been carefully assembled based on scientific merit and strategic collaboration, representing multidisciplinary strengths in thoracic surgery and lung transplant pulmonology that will complement our recognized research leadership. We have extensive experience in successful project management for large multi-site projects, and our expertise in developing standardized protocols and consensus documents will help to maximize the potential across all transplant centers. Ultimately, as key opinion leaders in a field that actively looks to us for guidance, our CATCH project outcomes are strongly positioned to have an immediate transformative impact by standardizing the field and ensuring that every patient in need of a lung transplant can receive one.

项目摘要 如今，末期肺部疾病患者的肺移植已越来越标准化 由于数十年的国际合作和合作伙伴关系，在世界范围内。 可以接受挽救生命的程序，并受益于大大改善的生存和生活质量。 霍弗（Howver），在三类高危患者中，进入肺移植仍然特别可变：1） 高度敏化的患者； 2）需要体外膜氧合的患者 移植（ECMO-BTT）和3）ACCYTORY遇险综合征的患者（ARDS， 共同相关的ARDS）。 研究了，没有明确的信任准则。 接受移植很大程度上取决于其计划的伴随，以接受没有移植的风险。 因此，足够的数据可以告知其如何最佳和安全执行。 对这些患者的选择和管理，在整个跨越 中心，最终损害了移植候选人。 在NIH肺移植财团的支持下，哭泣的捕获形成：创建访问 为高风险的候选人移植，其目标是改善这些候选人 有需要的患者。 佛罗里达大学，哥伦比亚大学和杨百翰和妇女医院的绩效超过400 肺部透明度，每个患者都有广泛但不同的经验。 我们的收集研究假设是，个人管理策略显着影响高风险 候选人的可能性 队列研究，我们旨在制定一种最佳和联合战略，以解决 这些高风险患者。 我们的团队根据科学的优点和战略合作仔细地集结了 胸手术和肺移植肺部学的多学科优势补充我们 公认的研究领导 多站点项目以及我们在开发标准化协议和共识文件方面的专业知识将有助于 最大化所有移植中心的潜力。 在我们看着我们的指导下，我们的捕捞项目成果很有位置，可以立即拥有 通过标准化领域并确保每个需要肺移植的患者来进行变革性影响 可以收到一个。