New trial aims to improve outcomes for organ transplantations

A new clinical trial has been awarded funding to determine whether reducing the time spent on ventilation for heart and lung transplant patients can improve their outcomes.

The trial will be led by Dr Sundeep Kaul, consultant in intensive care and respiratory medicine, at Royal Brompton and Harefield hospitals (RBHH), with funding provided by the pharmaceutical company Merk Sharpe & Dohme (MSD).

The trial aims to establish whether a particular combination of antibiotics will help reduce the time spent in intensive care for patients who have undergone heart and lung transplantations and are being treated for infection.

Infection is the main cause of death for patients after heart or lung transplantation, and lung infections in particular have a significant impact on the final outcome of organ transplantations.

Several types of bacteria can lead to infection, and in recent years there has been an increase in infections caused by bacteria which are resistant to multiple drugs, known as Multi-drug Resistance (MDR).

Patients who undergo heart and lung transplants are more at risk of MDR infections because they are frequently exposed to multiple antibiotic treatments, invasive procedures, immunosuppressive treatments and have repeated contact with healthcare settings.

The researchers believe that reducing the frequency of infections and the time a patient spends on invasive ventilatory support will have a positive impact on patient outcomes.

The research study will be testing a combination antibiotic treatment of ceftolozane and tazobactam (known as Zerbaxa) and investigating whether the treatment will result in a decrease in the time patients spend on the mechanical ventilator and/or tracheostomy, compared to routine antibiotic treatment.

The drug has already been shown to work well in non-transplant patients in critical care and Dr Kaul hopes to determine if this is also the case for transplant patients.

Dr Kaul said:

“Reducing the number and frequency of infections and the time patients spend in hospital is incredibly important. Doing so will improve the quality of life of our patients by getting them back to their normal life as soon as possible after transplantation..”

So, what’s next for Dr Kaul and his team?

“This study is just one project in a larger group of work on infections. Our next step will be to determine the effects of this drug on infections in patients with non-CF bronchiectasis.” Dr Kaul said.

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