Phase I Safety Study of Autologous Umbilical Cord Blood Derived Mononuclear Cells During Surgical Stage II Palliation of Hypoplastic Left Heart Syndrome
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Hypoplastic Left Heart Syndrome
- Sponsor
- Timothy J Nelson, MD, PhD
- Enrollment
- 30
- Locations
- 6
- Primary Endpoint
- Incidence of new and worsening adverse cardiac events
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
This is a Phase I study to determine the safety and feasibility of injections of autologous umbilical cord blood (UCB) cells into the right ventricle of Hypoplastic Left Heart Syndrome (HLHS) children undergoing a scheduled Glenn surgical procedure.
The investigators are doing this research study to find out if autologous stem cells from the individual's own umbilical cord blood can be used to strengthen the muscle of the right side of their heart. This will help determine the safety and feasibility of using cell-based regenerative therapy as an additional treatment for the management of HLHS.
Detailed Description
This study is a Phase I trial to determine the safety of autologous mononuclear cells (MNC) derived from umbilical cord blood for intramyocardial delivery into the right ventricle during a planned and non-emergent Stage II surgical palliation in subjects with HLHS. This is the first critical step towards applying autologous MNC therapy as an add-on regenerative intervention for congenital heart disease management. The choice of HLHS as the target disease for regenerative therapies in congenital heart disease management is multi-factorial and includes the following considerations: 1) Severity of of this incurable disease, 2) palliative nature and burden of long-term outcomes with a single right ventricular system, 3) three stages of planned surgical procedures that provide time points to adjunctively intervene, and 4) prenatal diagnosis enabling planned collection of UCB. An emerging goal for cardiac regeneration includes the application of cell-based technology to congenital heart disease, which is a favorable substrate due to the lack of fibrotic scaring, and the presence of a microenvironment that is expected to support ongoing cardiac proliferation and growth for functional remuscularization. This Phase I safety study will determine the feasibility of collection, processing, and delivery of autologous cells as used in adult cardiac regenerative protocols in the setting of HLHS surgical management.
Investigators
Timothy J Nelson, MD, PhD
Program Director
ReGen Theranostics, Inc.
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Incidence of new and worsening adverse cardiac events
Time Frame: Within 2 years following cell therapy treatment
The adverse cardiac events would include sustained/symptomatic ventricular arrhythmias, heart failure, myocardial infarction, cardiac infections, and unexpected cardiovascular surgery.
Percentage of subjects enrolled who undergo cell therapy treatment
Time Frame: Up to 2 years
Incidence of all-cause mortality
Time Frame: Within 2 years following cell therapy treatment
Percentage of subjects whose cells meet all cell release criteria
Time Frame: Up to 2 years
Secondary Outcomes
- Change in right ventricular ejection fraction at 3 months according to cardiac imaging with echocardiography(baseline, 3 months)
- Change in right ventricle tricuspid annular plane systolic excursion (TAPSE) at one month according to cardiac imaging with echocardiography(baseline, 1 month)
- Change in right ventricle TAPSE at 6 months according to cardiac imaging with echocardiography(baseline, 6 months)
- Change in right ventricle fractional area change at 6 months according to cardiac imaging with echocardiography(baseline, 6 months)
- Change in right ventricular ejection fraction at one month according to cardiac imaging with echocardiography(baseline, 1 month)
- Change in right ventricular ejection fraction at 6 months according to cardiac imaging with echocardiography(baseline, 6 months)
- Change in right ventricle TAPSE at 3 months according to cardiac imaging with echocardiography(baseline, 3 months)
- Change in right ventricle fractional area change at 3 months according to cardiac imaging with echocardiography(baseline, 3 months)
- Change in right ventricle fractional area change at one month according to cardiac imaging with echocardiography(baseline, 1 month)