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Safety of Autologous Cord Blood Cells in HLHS Patients During Norwood Heart Surgery

Phase 1
Completed
Conditions
Heart Defects, Congenital
Hypoplastic Left Heart Syndrome
Pediatric Disorder
Interventions
Biological: Autologous Human Placental Cord Blood Mononuclear Cells
Registration Number
NCT03431480
Lead Sponsor
Murdoch Childrens Research Institute
Brief Summary

This study aims to evaluate the safety and feasibility of coronary infusion of autologous placental cord blood mononuclear cells during the Norwood heart operation in newborn hypoplastic left heart syndrome (HLHS) patients.

Detailed Description

This is a Phase I, open label safety study. Autologous cord blood mononuclear cells (stem cell containing, cord blood buffy coat fraction) was delivered by coronary infusion during the Norwood cardiopulmonary bypass operation in 10 antenatally diagnosed HLHS patients within 2-3 days of birth. Safety and clinical status monitoring was performed to Stage II surgical intervention for HLHS (at approximately 3 months of age). Treated patients will continue to be assessed beyond the trial during follow up between Stage II and III (Fontan) surgical interventions.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • Male and females with antenatally diagnosed Hypoplastic Left Heart Syndrome (all types requiring Norwood operation)
  • Written informed consent by parents/legal guardian
  • Successful aseptic collection of autologous cord blood unit and transfer of buffy coat mononucleocyte fraction to cold storage pending cardiac surgery within 2-4 days
Exclusion Criteria

Patient:

  • does not have autologous cord blood cells available at the time of cardiopulmonary bypass surgery
  • has evidence of arrhythmia requiring anti-arrhythmia therapy
  • has an additional congenital diagnosis that contributes to conditions such as an immune system disorder, immune deficiency, complex metabolic disorder, brain dysplasia or progressive neurological degenerative disorder
  • has other clinical complexity deemed by the cardiac surgeon to make the patient unsuitable for inclusion in the trial

Mother:

• is serum positive for HIV, hepatitis or other significant pathogen and has known allergies to penicillin, streptomycin or other antibiotic

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
hCBMNCAutologous Human Placental Cord Blood Mononuclear CellsAutologous human placental cord blood mononuclear cells (buffy coat fraction)
Primary Outcome Measures
NameTimeMethod
Incidence of adverse cardiac events1 month

Monitoring of adverse events including death, heart or other organ failure, myocardial infarction, sustained/symptomatic ventricular tachycardia, bleeding, stroke

Secondary Outcome Measures
NameTimeMethod
Change in right ventricular end-diastolic volume (% units)baseline, 1 month, 3 months, 12 months

Measured by cardiac imaging with serial echocardiography and MRI scans

Change in right ventricular function -fractional shortening (% units)baseline, 1 month, 3 months, 12 months

Measured by cardiac imaging with serial echocardiography and MRI scans

Change in right ventricular end-diastolic wall thickness (% units)baseline, 1 month, 3 months, 12 months

Measured by cardiac imaging with serial echocardiography and MRI scans

Change in right ventricular end-systolic volume (% units)baseline, 1 month, 3 months, 12 months

Measured by cardiac imaging with serial echocardiography and MRI scans

Increase in body weightbaseline, 1 month, 3 months, 12 months

Body weight measured in kilograms

Composite measure of height and head circumferencebaseline, 1 month, 3 months, 12 months

Body height and head circumference measured in meters

Trial Locations

Locations (1)

Royal Children's Hospital

🇦🇺

Melbourne, Victoria, Australia

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