NCT02566577

Brief Summary

The purpose of this study is to determine how red blood cell transfusions, particularly the length of storage time of units of packed red blood cells, affects the cardiovascular function in patients receiving transfusions. This study will also determine the most ideal way of storing and processing blood, and assess how transfusion affects a person's ability to exercise and how their blood vessels relax and contract.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
15

participants targeted

Target at below P25 for phase_4

Timeline
Completed

Started Jul 2013

Longer than P75 for phase_4

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 2013

Completed
2.3 years until next milestone

First Submitted

Initial submission to the registry

October 1, 2015

Completed
1 day until next milestone

First Posted

Study publicly available on registry

October 2, 2015

Completed
2.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2018

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

May 24, 2019

Completed
Last Updated

May 24, 2019

Status Verified

May 1, 2019

Enrollment Period

4.7 years

First QC Date

October 1, 2015

Results QC Date

March 29, 2019

Last Update Submit

May 3, 2019

Conditions

Keywords

Chronic anemiaCardiopulmonary testingTransfusion-dependent anemia

Outcome Measures

Primary Outcomes (2)

  • Change in Flow-mediated Vasodilation (FMD)

    Brachial artery flow-mediated dilation (FMD) will be performed by using ultrasonography. The brachial artery of the non-dominant arm will be imaged using a high-resolution 13 MHz ultrasound transducer. A blood pressure cuff on the forearm will be inflated to supra-systolic pressures to produce 5 minutes of ischemia. After cuff deflation, imaging of the brachial artery will be performed continuously for the next 120 seconds and the flow-mediated dilation will be calculated. Change in FMD is the percent change in the diameter of the brachial artery from baseline (prior to transfusion) to Day 1 (first post-transfusion day). A higher FMD indicates better nitric oxide-dependent endothelial function.

    Baseline (prior to transfusion), Day 1 (first post-transfusion day)

  • Change in Reactive Hyperemic Index (RHI)

    Reactive Hyperemia Index (RHI) will be measured using Pulsatile Arterial Tonometry (PAT). Baseline blood pressure of both hands is measured and PAT probes are placed one on each hand at the same finger (fingers 2, 3 or 4). Following an equilibration period of 10 minutes, the blood pressure cuff will be inflated to 60 mmHg above systolic pressure for 5 minutes followed by deflation of the cuff and the pulsatile recordings from both study and control fingers will be measured. RHI will be calculated from the ratio of the digital pulse volume during reactive hyperemia (following cuff deflation) and baseline. A higher RHI indicates better nitric oxide-dependent endothelial function.

    Baseline (prior to transfusion), Day 1 (first post-transfusion day)

Secondary Outcomes (9)

  • Maximal Oxygen Uptake (VO2Max)

    Day 1 (first post-transfusion day)

  • Respiratory Exchange Ratio (RER):

    Day 1 (first post-transfusion day)

  • O2 Pulse

    Day 1 (first post-transfusion day)

  • Peak VO2 Lean

    Day 1 (first post-transfusion day)

  • Change in Oxidative Stress Markers

    Baseline (prior to transfusion), Day 1 (first post-transfusion day)

  • +4 more secondary outcomes

Study Arms (2)

Fresh RBC transfusion/Storage-aged RBC transfusion

ACTIVE COMPARATOR

Subjects will receive a transfusion of packed red blood cell (RBC) units of fresh blood (\<10 days old) followed by a transfusion of packed RBC units of storage-aged (\>21 days old) blood.

Biological: Fresh red blood cell (RBC) transfusionBiological: Storage-aged red blood cell (RBC) transfusionDevice: Electronic infusion pump

Storage-aged RBC transfusion/Fresh RBC transfusion

ACTIVE COMPARATOR

Subjects will receive a transfusion of packed red blood cell (RBC) units of storage-aged (\>21 days old) blood followed by a transfusion of packed RBC units of fresh blood (\<10 days old).

Biological: Fresh red blood cell (RBC) transfusionBiological: Storage-aged red blood cell (RBC) transfusionDevice: Electronic infusion pump

Interventions

1 or 2 cross-matched, packed red blood cells (RBC) units from fresh (\<10 days old) blood, as ordered by the attending physician, will be given as an intravenous infusion via a programmable electronic infusion pump (Baxter, Inc) over a period of 1 hour per unit.

Fresh RBC transfusion/Storage-aged RBC transfusionStorage-aged RBC transfusion/Fresh RBC transfusion

1 or 2 cross-matched, packed red blood cells (RBC) units from storage-aged (\>21 days old) blood, as ordered by the attending physician, will be given as an intravenous infusion via a programmable electronic infusion pump (Baxter, Inc) over a period of 1 hour per unit.

Fresh RBC transfusion/Storage-aged RBC transfusionStorage-aged RBC transfusion/Fresh RBC transfusion

A programmable, electronic infusion pump (Baxter, Inc) will be used for intravenous transfusion of units of packed red blood cells (RBC). The pump will be programmed to deliver 1 unit of packed RBC per hour.

Fresh RBC transfusion/Storage-aged RBC transfusionStorage-aged RBC transfusion/Fresh RBC transfusion

Eligibility Criteria

Age21 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • \- Subjects with any condition resulting in transfusion-dependent anemia

You may not qualify if:

  • Age \<21 or \>80 years
  • Pregnancy
  • Acute infection in previous 4 weeks
  • Active substance abuse within the past year
  • Inability to give informed consent
  • Inability to return for follow-up
  • The presence of alloantibodies that would limit the blood bank's ability to obtain correctly aged red blood cell (RBC) units

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Emory University Hospital

Atlanta, Georgia, 30322, United States

Location

Related Publications (1)

  • Radford M, Estcourt LJ, Sirotich E, Pitre T, Britto J, Watson M, Brunskill SJ, Fergusson DA, Doree C, Arnold DM. Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support. Cochrane Database Syst Rev. 2024 May 23;5(5):CD011305. doi: 10.1002/14651858.CD011305.pub3.

MeSH Terms

Interventions

Erythrocyte CountBlood Transfusion

Intervention Hierarchy (Ancestors)

Blood Cell CountCell CountCytological TechniquesClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisHematologic TestsInvestigative TechniquesCell Physiological PhenomenaBlood Physiological PhenomenaCirculatory and Respiratory Physiological PhenomenaBiological TherapyTherapeutics

Results Point of Contact

Title
Arshed A. Quyyumi
Organization
Emory University

Study Officials

  • Arshed Quyyumi, MD, FACC

    Emory University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

October 1, 2015

First Posted

October 2, 2015

Study Start

July 1, 2013

Primary Completion

March 1, 2018

Study Completion

March 1, 2018

Last Updated

May 24, 2019

Results First Posted

May 24, 2019

Record last verified: 2019-05

Locations