F-CUSToS: Feasibility study of Custodiol-HTK vs St Thomas' Solution in cardiac transplantation

  • Research type

    Research Study

  • Full title

    Feasibility study for Randomised Controlled Trial of Custodiol-HTK vs St Thomas’ solution for cardioplegia and cold static storage of UK donor hearts in cardiac transplantation (F-CUSToS)

  • IRAS ID

    1007011

  • Contact name

    Marius Berman

  • Contact email

    marius.berman@nhs.net

  • Sponsor organisation

    Royal Papworth Hospital NHS Foundation Trust

  • ISRCTN Number

    ISRCTN11985512

  • Research summary

    Background: Donor hearts are injected with a preservative fluid to protect them during transport to the transplant recipient. Currently, there are two different fluids used for this purpose in the UK, St Thomas’ solution and Custodiol-HTK. St Thomas’ is the standard fluid used in most UK transplants. Some animal studies and data from previous transplants have suggested that Custodiol-HTK may preserve the heart better. However, we do not know if this is true, because no one has ever tested this in a controlled way in humans.

    Aims: We aim to conduct a randomised controlled trial (RCT) - the gold standard in research - to compare the two fluids. To test whether there is truly a difference, we need to collect data from around 450 patients. This will take a long time. Therefore, we first want to test if enough patients will consent to take part in the study to make it realistically possible. This is called a feasibility study.

    Methods: We intend to ask all UK heart transplant recipients whether they wish to be involved in the trial. If they do, we will randomly allocate hearts to receive either Custodiol-HTK or St Thomas' solution before they are transplanted. We will do this for 50 hearts, which should take less than 1 year. The primary aim of the project is to see if more than two-thirds of eligible heart transplant recipients consent to take part and go on to receive a heart that has been correctly randomised.

    Benefits: We believe that by conducting this feasibility study we can prove that it is possible to conduct the RCT. We believe that by conducting the RCT we can finally answer the question: “Which preservative fluid should we use in heart transplantation?” and, if one is shown to be better, change practice in the UK, saving the lives of transplant recipients.

  • REC name

    East of England - Cambridge South Research Ethics Committee

  • REC reference

    23/EE/0224

  • Date of REC Opinion

    23 Nov 2023

  • REC opinion

    Further Information Favourable Opinion