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UC-MSC Infusion for HBV-Related Acute-on-Chronic Liver Failure

Phase 2
Conditions
Liver Failure
Interventions
Drug: umbilical cord blood mesenchymal stem cells
Registration Number
NCT02812121
Lead Sponsor
Sun Yat-sen University
Brief Summary

Hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) is a severe disease with high mortality. Our previous study have demonstrated that peripheral infusion of bone marrow-derived mesenchymal stromal cells (MSCs) weekly for 4 times is safe and improves 24 weeks survival rate of ACLF patients. In this study, we intend to assess the safety and efficacy of umbilical cord blood derived MSCs for HBV-related ACLF patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
261
Inclusion Criteria
  1. Patients with ACLF-which is characterized by acute hepatic insult manifesting as jaundice (serum total bilirubin ≥ 10×ULN umol/L) and coagulopathy (international normalized ratio≥ 1.5 or prothrombin activity < 40%), complicated within 4 weeks by ascites and/or encephalopathy as determined by physical examination, in patients with previously diagnosed or undiagnosed chronic liver disease;
  2. Positive serum hepatitis B surface antigen (HBsAg) for more than 6 months;
  3. End-stage liver disease scores ranging from 17-30,; 4.18-65 years of age.
Exclusion Criteria
  1. Serious complications within the previous 2 months (e.g. gastrointestinal bleeding, serious infection );
  2. Concomitant autoimmune disease;
  3. Superinfection with other hepatitis viruses;
  4. Important organ dysfunctions not due to liver disease or malignancies;
  5. Pregnancy and lactation;
  6. Liver tumor or nodules secondary to cirrhosis proven by ultrasound, computerized tomography (CT), or magnetic resonance (MR) imaging;
  7. Bioartificial liver support therapy;
  8. Previous liver transplantation.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group MSC-2umbilical cord blood mesenchymal stem cellsPatients in Group MSC-1 received standard medical treatment and infusions of umbilical cord blood mesenchymal stem cells via peripheral veins once a week for 4 weeks.
Group MSC-1umbilical cord blood mesenchymal stem cellsPatients in Group MSC-1 received standard medical treatment and infusions of umbilical cord blood mesenchymal stem cells via peripheral veins once a week for 8 weeks.
Primary Outcome Measures
NameTimeMethod
The survival time of patients after UC-MSC infusions.52 weeks
The incidence of adverse reactions after umbilical cord blood derived mesenchymal stem cells (UC-MSC) infusions.52 weeks
Secondary Outcome Measures
NameTimeMethod
The influence on levels of ALB(g/L) after UC-MSC infusions1,2,3,4,8,12,24,36,52weeks
The influence on levels of TBil (umol/L) after UC-MSC infusions1,2,3,4,8,12,24,36,52weeks
The influence on levels of MELD score, SOFA score and CTP score after UC-MSC infusions1,2,3,4,8,12,24,36,52weeks
Comparison of levels of KIR2DL1 among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
Comparison of levels of perforin among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
The influence on levels of INR after UC-MSC infusions1,2,3,4,8,12,24,36,52weeks
Comparison of levels of NKG2A among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
Comparison of levels of KIR2DL3 among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
Comparison of levels of FasL among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
The influence on levels of ALT (U/L) and AST (U/L) after UC-MSC infusions1,2,3,4,8,12,24,36,52weeks
Comparison of levels of KIR3DL1 among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
Comparison of levels of NKG2D among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
Comparison of levels of NKP46 among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
Comparison of levels of gramzymeB among the groups after UC-MSC infusions2,4,8,12,24,36,52 weeks
The incidence of fatal complications after UC-MSC infusions.52 weeks
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