Treatment With Human Umbilical Cord-derived Mesenchymal Stem Cells for Decompensated Cirrhosis

Last updated: November 3, 2021
Sponsor: Beijing 302 Hospital
Overall Status: Active - Recruiting

Phase

2

Condition

Hepatic Fibrosis

Hyponatremia

Scar Tissue

Treatment

N/A

Clinical Study ID

NCT05121870
NCRC-ID202105
  • Ages 18-75
  • All Genders

Study Summary

Decompensated cirrhosis has a high overall mortality rate. There is a large unmet need for safe and alternative therapeutic potions. This clinical trial is to inspect the efficiency and safety of mesenchymal stem cells (MSCs) therapy for decompensated cirrhosis.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Willing to provide written informed consent;
  2. Aged 18 to 75 years (including 18 and 75 years), male or female;
  3. Patients diagnosed with decompensated liver cirrhosis based on clinical findings,laboratory tests, imaging findings and/or representative pathological findings (decompensated liver cirrhosis is defined as the occurrence of at least one seriouscomplication, including esophageal and gastric varices bleeding, hepaticencephalopathy, ascites, spontaneous bacterial peritonitis and other seriouscomplications);
  4. Child-Turcotte-Pugh (CTP) score 7 to 12 points.

Exclusion

Exclusion Criteria:

  1. Appearance of active variceal bleeding, overt hepatic encephalopathy (HE), refractoryascites or hepatorenal syndrome within 1 month prior to screening visit.
  2. Uncontrolled severe infection within 2 weeks of screening.
  3. Hepatitis B virus (HBV) DNA ≥ detection limit at the time of screening.
  4. Patients with hepatitis B virus-related decompensated liver cirrhosis may discontinueantiviral therapy during the study, or those who with antiviral therapy for HBV forless than 12 months.
  5. Patients with hepatitis C virus-related decompensated liver cirrhosis may discontinueantiviral therapy during the study, or those who with antiviral therapy for HCV forless than 12 months.
  6. Patients under treatment with corticosteroids for autoimmune hepatitis for less than 6months.
  7. Trans-jugular intrahepatic portosystemic shunts (TIPS) insertion within 6 months priorto study inclusion.
  8. Active drinkers with alcohol-related decompensated cirrhosis are unwilling to stopalcohol abuse after inclusion.
  9. Severe jaundice (serum total bilirubin level ≥ 170μmol/L); Significant renalinsufficiency (serum creatinine ≥ 1.2 times upper normal limit); Severe electrolyteabnormality (serum sodium level < 125 mmol/L); Severe leukopenia (white blood cellcount < 1 × 10E9/L).
  10. Patients with biliary obstruction, hepatic vein, portal vein, splenic vein thrombosisand portal vein spongiosis.
  11. Patients with surgical history such as splenic cut-off flow and portal body shunt.
  12. Patients with confirmed or suspected malignancies.
  13. Patients with a prior history of major organ transplantation or complicated withsignificant disease of heart, lung, kidney, blood, endocrine and other systems.
  14. Drug abuse, drug dependence and patients who receive methadone treatment or withpsychosis.
  15. HIV seropositivity.
  16. Those who have received blood transfusion or other blood products within 1 month priorto screening visit.
  17. Pregnancy, lactation or with recent fertility plan.
  18. Highly allergic or have a history of severe allergies.
  19. Participants in other clinical trials within the last 3 months.
  20. Any other clinical condition which the investigator considers would make the patientunsuitable for the trial.

Study Design

Total Participants: 240
Study Start date:
September 01, 2021
Estimated Completion Date:
December 31, 2023

Study Description

Decompensated cirrhosis has a high overall mortality rate. Liver transplantation is still the most effective treatment for decompensated cirrhosis. However, the shortage of matched liver sources, high costs, and rejection after liver transplantation restrict the development of liver transplantation.

Mesenchymal stem cells (MSC) are a kind of pluripotent stem cells belonging to mesoderm, which mainly exist in connective tissue and organ interstitium. At present, MSC can be isolated and prepared from bone marrow, fat, synovium, bone, muscle, lung, liver, pancreas and amniotic fluid and umbilical cord blood . Due to its wide range of sources and self-proliferation and differentiation ability, MSCs have therapeutic potential for many diseases, including acute and chronic liver diseases.

In recent years, our team has carried out a series of clinical trials using umbilical cord-derived MSCs to treat patients with end-stage liver disease, decompensated cirrhosis, primary biliary cholangitis, and status after liver transplantation and found that MSCs therapy can significantly improve patient liver function, reduce post-transplantation rejection, reduce complications, improve quality of life, and improve survival. Other investigators have also found in clinical trials with MSCs from different sources that treatment with MSCs can improve MELD scores or liver function levels to varying degrees. However, some studies have found no significant difference between the treatment group and the control group, and MSCs may differentiate into hepatic stellate cells and have the risk of promoting liver fibrosis, it is believed that MSCs do not favor the improvement of liver function in these studies. Therefore, the therapeutic effects of MSCs need to be further validated by larger multicenter randomized controlled clinical trials.

The investigators will do a prospective, double-blind, multicentre, randomised trial to assess treatment with three intravenous doses of MSCs compared with placebo. 240 decompensated cirrhosis patients will be recruited in China.120 patients will receive i.v. transfusion 3 times of MSCs (6.0×10E7 cells per time) and the standard of care as the treated group. In addition, the 120 patients will receive placebo and standard of care as control group.

Connect with a study center

  • The First Hospital of Lanzhou University

    Lanzhou, Gansu
    China

    Site Not Available

  • Hainan hospital of Chinese PLA General Hospital

    Sanya, Hainan
    China

    Site Not Available

  • Renmin Hospital of Wuhan University

    Wuhan, Hubei
    China

    Site Not Available

  • Shanghai Changzheng Hospital

    Shanghai, Shanghai 200003
    China

    Site Not Available

  • Beijing 302 Hospital

    Beijing,
    China

    Active - Recruiting

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