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GATT-Patch Versus TachoSil in Liver Surgery

Primary Purpose

Intraoperative Bleeding, Hemorrhage, Surgical, Liver Diseases

Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
GATT-Patch
TachoSil
Sponsored by
GATT Technologies BV
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intraoperative Bleeding focused on measuring Hemostatic patch, GATT-Patch, TachoSil, Liver surgery, Hemostasis

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject is scheduled to undergo elective open surgery on the liver;
  • Subject is willing and able to give written informed consent for the clinical investigation participation;
  • Subjects is 22 years of age or older at the time of enrollment; and
  • Subject has been informed of the nature of the clinical investigation.

A subject must meet all of the following intra-operative inclusion criteria to be enrolled into the clinical investigation:

  • Subject in whom the Investigator is able to identify a target bleeding site at the liver resection plane for which any applicable conventional means for hemostasis (e.g. suture, ligature or cautery) are ineffective or impractical, and the choice is made to use a hemostatic agent to stop the bleeding; and
  • Subject has a target bleeding site with a SBSS of 1, 2, or 3 (e.g. reflecting minimal, mild or moderate bleeding severities).

Exclusion Criteria:

  • The target bleeding site is from a large defect in an artery or vein that requires vascular reconstruction with maintenance of vessel patency;
  • Subject is scheduled to undergo surgery on other organs than the liver and its associated biliary and vascular system; • Subject is scheduled to undergo a staged liver surgery procedure (e.g., Associating Liver Partition and Portal vein ligation for Staged hepatectomy [ALPPS])
  • Subject is taking multiple antithrombotic therapies in therapeutic dosage up to the time of surgery, but allowing exclusive use of acetylsalicylic acid;
  • Subject has platelet count <100 x 109/L, an activated partial thrombin time of >100s, or international normalized ratio >2.5;
  • Subject has a total bilirubin level of ≥2.5 mg/dl;
  • Subject is pregnant, planning on becoming pregnant or actively breastfeeding during the 3-month follow-up period;
  • Subject has a known hypersensitivity to brilliant blue (FD&C Blue #1), porcine gelatin, or horse proteins;
  • Subject who has religious objections to receiving products with components of animal (porcine or equine) or human origin;
  • Subject has an active or suspected infection at the bleeding site;
  • Subject in whom the investigational device will be used at the site of a synthetic graft or patch implant;
  • Subject has a life expectancy of less than 3 months;
  • Subject has a documented severe congenital or acquired immunodeficiency;
  • Subject has had or has planned to receive any organ transplantation;
  • Subject undergoes surgery with the indication of being a living liver donor;
  • Subject is currently participating or has participated in another clinical investigation within the past 30 days that may affect the endpoints of the study, such as trials related to the surgical procedure, and on anti-coagulation;
  • Subject is not appropriate for inclusion in the clinical investigation, per the medical opinion of the Investigator; and
  • Subject has any incidental (pre- and peri-operative) findings deemed by the Investigator to potentially jeopardize the safety or welfare of the subject.

Sites / Locations

  • University of Southern CaliforniaRecruiting
  • Washington UniversityRecruiting
  • Rutgers UniversityRecruiting
  • Weill-CornellRecruiting
  • Atrium Health
  • Intermountain HealthcareRecruiting
  • Heidelberg University HospitalRecruiting
  • University Hospital Ulm
  • University Medical Center GroningenRecruiting
  • Radboud University Medical CenterRecruiting
  • Erasmus MCRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

GATT-Patch

TachoSil

Arm Description

Hemostatic patch

Hemostatic patch

Outcomes

Primary Outcome Measures

Rate of hemostasis at 3 minutes without rebleeding at the 10-minute time point
SBSS 0

Secondary Outcome Measures

Mean time to hemostasis (seconds)
SBSS 0
Kaplan-Meier estimated distribution of time to hemostasis
SBSS 0
Rate of subjects with treatment failure
SBSS 1-5 at the 10 minute timepoint
Rate of subjects with rebleeding after 10 minutes but before subject closure
SBSS 1-5 after initially SBSS 0
Rate of subjects with hemostasis at 30, 60, 90, 120, 150, 180, 210, 240, 270, 300, 360, 420, 540 and 600 seconds
SBSS 0-5

Full Information

First Posted
April 29, 2022
Last Updated
May 4, 2023
Sponsor
GATT Technologies BV
Collaborators
Syneos Health
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1. Study Identification

Unique Protocol Identification Number
NCT05385952
Brief Title
GATT-Patch Versus TachoSil in Liver Surgery
Official Title
A Prospective, Multicenter, Randomized Clinical Investigation Evaluating the Safety and Efficacy of GATT-Patch Versus TachoSil for Hemostasis During Open Liver Surgery
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 4, 2022 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GATT Technologies BV
Collaborators
Syneos Health

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a pre-market, prospective, randomized (2:1), multicenter, multi-national pivotal clinical investigation. The purpose of this investigation is to determine the clinical safety and performance of GATT-Patch as compared with TachoSil for the management of minimal, mild, or moderate bleeding during elective open liver surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intraoperative Bleeding, Hemorrhage, Surgical, Liver Diseases
Keywords
Hemostatic patch, GATT-Patch, TachoSil, Liver surgery, Hemostasis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Randomization 2:1
Masking
Participant
Masking Description
Patients will be blinded to randomized treatment and treatment used.
Allocation
Randomized
Enrollment
130 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GATT-Patch
Arm Type
Experimental
Arm Description
Hemostatic patch
Arm Title
TachoSil
Arm Type
Active Comparator
Arm Description
Hemostatic patch
Intervention Type
Device
Intervention Name(s)
GATT-Patch
Intervention Description
GATT-Patch is a sterile, flexible and resorbable hemostatic sealing patch. It presents as a blue, soft, flexible, porcine gelatin fiber-based carrier impregnated with an NHS-POx / NU-POx granulate. GATT-Patch measures 10 cm long by 5 cm wide. GATT-Patch is active and can be applied on both sides. Blue color is an aid to visualize GATT-Patch when applied onto a bleeding location. GATT-Patch is indicated for use as an adjunct to hemostasis in surgery for minimal, mild or moderate bleeding sites when control of bleeding by standard surgical techniques (such as suture, ligature or cautery) is ineffective or impractical. GATT-Patch is intended to be used for management of hemorrhage during surgeries on the liver.
Intervention Type
Drug
Intervention Name(s)
TachoSil
Intervention Description
TachoSil is a topical fibrin sealant patch consisting of human fibrinogen and human thrombin coated onto an equine collagen sponge. TachoSil is a fibrin sealant patch indicated for use with manual compression in adult and pediatric patients as an adjunct to hemostasis in cardiovascular and hepatic surgery, when control of bleeding by standard surgical techniques (such as suture, ligature or cautery) is ineffective or impractical.
Primary Outcome Measure Information:
Title
Rate of hemostasis at 3 minutes without rebleeding at the 10-minute time point
Description
SBSS 0
Time Frame
During surgical procedure
Secondary Outcome Measure Information:
Title
Mean time to hemostasis (seconds)
Description
SBSS 0
Time Frame
During surgical procedure
Title
Kaplan-Meier estimated distribution of time to hemostasis
Description
SBSS 0
Time Frame
During surgical procedure
Title
Rate of subjects with treatment failure
Description
SBSS 1-5 at the 10 minute timepoint
Time Frame
During surgical procedure
Title
Rate of subjects with rebleeding after 10 minutes but before subject closure
Description
SBSS 1-5 after initially SBSS 0
Time Frame
During surgical procedure
Title
Rate of subjects with hemostasis at 30, 60, 90, 120, 150, 180, 210, 240, 270, 300, 360, 420, 540 and 600 seconds
Description
SBSS 0-5
Time Frame
During surgical procedure
Other Pre-specified Outcome Measures:
Title
Procedure duration
Description
Time in minutes
Time Frame
During surgical procedure
Title
Estimated blood loss
Description
mL
Time Frame
During surgical procedure
Title
Number and type of blood transfusions
Description
Platelets, Erythrocytes, Plasma
Time Frame
During surgical procedure
Title
Number and type of blood transfusions
Description
Platelets, Erythrocytes, Plasma
Time Frame
During hospitalization up to hospital discharge after the surgical procedure, estimated up to 30 days
Title
Mean duration of ICU stay
Description
Time in hours
Time Frame
From surgery to discharge from the ICU, estimated up to 30 days
Title
Mean total hospitalization time
Description
Time in days
Time Frame
During hospitalization up to hospital discharge after the surgical procedure, estimated up to 30 days
Title
Aspect of postoperative drainage
Description
Serous, sanguineous, serosanguineous, other Sanguineous Serosanguinous Serous, Sanguineous, Serosanguineous, Purulent, Other
Time Frame
During hospitalization up to hospital discharge after the surgical procedure, estimated up to 30 days
Title
Rate of subjects requiring reoperation
Description
Occurrence yes/no
Time Frame
During postoperative 3-months follow-up
Title
Rate of subjects with liver resection surface complications on ultrasound
Description
Fluid collection, biloma, hematoma, patch encapsulation, patch rolling up on the surface
Time Frame
At 6 weeks follow-up visit
Title
Amount of hemostatic material needed versus bleeding surface
Description
cm2 patch per cm2 bleeding
Time Frame
During surgical procedure
Title
System Usability Score (SUS) user satisfaction questionnaire
Description
Likert scale (strongly disagree, disagree, neutral, agree, strongly agree) with (strongly) agreeing meaning a better outcome for uneven questions and (strongly) disagreeing meaning a better outcome for even questions
Time Frame
At completion of the surgical procedure, at day 0
Title
GATT-Patch device-specific user satisfaction questionnaire
Description
Likert scale (strongly disagree, disagree, neutral, agree, strongly agree) with (strongly) agreeing meaning a better outcome
Time Frame
At completion of the surgical procedure, at day 0
Title
Local recurrence of liver cancer at the resection
Description
Occurrence yes/no
Time Frame
5 years
Title
Cancer-free survival
Description
Occurrence yes/no
Time Frame
5 years
Title
Overall survival
Description
Occurrence yes/no
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is scheduled to undergo elective open surgery on the liver; Subject is willing and able to give written informed consent for the clinical investigation participation; Subjects is 22 years of age or older at the time of enrollment; and Subject has been informed of the nature of the clinical investigation. A subject must meet all of the following intra-operative inclusion criteria to be enrolled into the clinical investigation: Subject in whom the Investigator is able to identify a target bleeding site at the liver resection plane for which any applicable conventional means for hemostasis (e.g. suture, ligature or cautery) are ineffective or impractical, and the choice is made to use a hemostatic agent to stop the bleeding; and Subject has a target bleeding site with a SBSS of 1, 2, or 3 (e.g. reflecting minimal, mild or moderate bleeding severities). Exclusion Criteria: The target bleeding site is from a large defect in an artery or vein that requires vascular reconstruction with maintenance of vessel patency; Subject is scheduled to undergo surgery on other organs than the liver and its associated biliary and vascular system; • Subject is scheduled to undergo a staged liver surgery procedure (e.g., Associating Liver Partition and Portal vein ligation for Staged hepatectomy [ALPPS]) Subject is taking multiple antithrombotic therapies in therapeutic dosage up to the time of surgery, but allowing exclusive use of acetylsalicylic acid; Subject has platelet count <100 x 109/L, an activated partial thrombin time of >100s, or international normalized ratio >2.5; Subject has a total bilirubin level of ≥2.5 mg/dl; Subject is pregnant, planning on becoming pregnant or actively breastfeeding during the 3-month follow-up period; Subject has a known hypersensitivity to brilliant blue (FD&C Blue #1), porcine gelatin, or horse proteins; Subject who has religious objections to receiving products with components of animal (porcine or equine) or human origin; Subject has an active or suspected infection at the bleeding site; Subject in whom the investigational device will be used at the site of a synthetic graft or patch implant; Subject has a life expectancy of less than 3 months; Subject has a documented severe congenital or acquired immunodeficiency; Subject has had or has planned to receive any organ transplantation; Subject undergoes surgery with the indication of being a living liver donor; Subject is currently participating or has participated in another clinical investigation within the past 30 days that may affect the endpoints of the study, such as trials related to the surgical procedure, and on anti-coagulation; Subject is not appropriate for inclusion in the clinical investigation, per the medical opinion of the Investigator; and Subject has any incidental (pre- and peri-operative) findings deemed by the Investigator to potentially jeopardize the safety or welfare of the subject.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Stuart Head, MD PhD
Phone
+31645306042
Email
s.head@gatt-tech.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ingrid Fossan
Phone
+31653538551
Email
i.fossan@gatt-tech.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Guarrera
Organizational Affiliation
Rutgers New Jersey Medical School, Newark, NJ, USA
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hans de Wilt
Organizational Affiliation
Radboud University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Navpreet Kaur
First Name & Middle Initial & Last Name & Degree
Valentina Rodina
Facility Name
Washington University
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Jason Wellen
First Name & Middle Initial & Last Name & Degree
Kathleen McDonnell
Facility Name
Rutgers University
City
Newark
State/Province
New Jersey
ZIP/Postal Code
07103
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Flavio Paterno
First Name & Middle Initial & Last Name & Degree
Prof James Guarrera
Facility Name
Weill-Cornell
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Ben Samstein
First Name & Middle Initial & Last Name & Degree
Mateo Noriega
Facility Name
Atrium Health
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof David Iannitti
First Name & Middle Initial & Last Name & Degree
Katheryn Peterson
Facility Name
Intermountain Healthcare
City
Murray
State/Province
Utah
ZIP/Postal Code
84111
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Jean Botha
First Name & Middle Initial & Last Name & Degree
Jake Krong
Facility Name
Heidelberg University Hospital
City
Heidelberg
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Frank Pianka
First Name & Middle Initial & Last Name & Degree
Bahar Ünlü
Facility Name
University Hospital Ulm
City
Ulm
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Patrick Heger
First Name & Middle Initial & Last Name & Degree
Alina Danielak-Okonji
Facility Name
University Medical Center Groningen
City
Groningen
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr Suomi Fouraschen
First Name & Middle Initial & Last Name & Degree
Leanne van der Plas
Facility Name
Radboud University Medical Center
City
Nijmegen
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Hans de Wilt
First Name & Middle Initial & Last Name & Degree
Linda Garms
Facility Name
Erasmus MC
City
Rotterdam
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Prof Kees Verhoef
First Name & Middle Initial & Last Name & Degree
Prof Robert Porte

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
28699748
Citation
Boerman MA, Roozen E, Sanchez-Fernandez MJ, Keereweer AR, Felix Lanao RP, Bender JCME, Hoogenboom R, Leeuwenburgh SC, Jansen JA, Van Goor H, Van Hest JCM. Next Generation Hemostatic Materials Based on NHS-Ester Functionalized Poly(2-oxazoline)s. Biomacromolecules. 2017 Aug 14;18(8):2529-2538. doi: 10.1021/acs.biomac.7b00683. Epub 2017 Jul 25.
Results Reference
background
PubMed Identifier
34536065
Citation
Roozen EA, Warle MC, Lomme RMLM, Felix Lanao RP, van Goor H. New polyoxazoline loaded patches for hemostasis in experimental liver resection. J Biomed Mater Res B Appl Biomater. 2022 Mar;110(3):597-605. doi: 10.1002/jbm.b.34938. Epub 2021 Sep 18.
Results Reference
background
Links:
URL
http://www.gatt-tech.com
Description
GATT Technologies B.V. website

Learn more about this trial

GATT-Patch Versus TachoSil in Liver Surgery

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