HBV
Conditions
Brief summary
The purpose of this study was to observe the safety ,tolerability ,Efficacy dose of human umbilical cord mesenchymal stem cells in patients of decompensated liver cirrhosis with HBV.
Detailed description
Investigators plan to recruit 24 voluntary patients of decompensate liver cirrhosis with HBV, dividing them into 3 group：1) low-dose group: 100mL with 2.5×10\^7 cells；2) medium-dose group: 100mL with 5.0×10\^7 cells；3) high-dose group: 100mL with 1.0×10\^8 cells. Each group contains 8 patients. Investigators treat the participants with human umbilical cord mesenchymal stem cells via venous transfusion. First investigators arrange a whole test for participants, such as vital sign examination, laboratory test, ECG, CT, MRI, ultrasound etc. Investigators screen these patients with a complete eligibility criteria. Then investigators proceed the therapy in the 1st, 8th and 15th day. There are 8 times of follow-up visit for these patients, 4 times of those are proceeded during the hospitalization, while other 4 times happens after the discharge. The follow-up visit includes vital sign examination, laboratory test, ECG, CT, MRI, ultrasound, Child-Pugh grade, MELD grade, SF-36 test. These follow-up visit last 24 weeks since the first treatment. After that, investigators also arrange a survival visit through phone or clinic each 6 months, lasting another 1.5 years. The main object of this research is investigating the survival rate, promotion of the liver function, improvement of health, safety of hUC-MSCs, tolerability of patients, for exploring a new way for the therapy of decompensated liver cirrhosis with HBV.
Interventions
BIOLOGICALhUCMSCs
Human umbilical cord mesenchymal stem cell preparation, 100ml/ bag, containing 2.5×107 cells, 5.0×107 cells, 1.0 x 108 cells
Sponsors
Zhongnan Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
We allocate 24 participants into 3 group, low-dose, medium-dose and high-dose group. It is going to proceeded sequential from low-dose group to high-dose group. Next group is allowed to be started only the last group has been finished. 1. Low-dose group: 100mL human umbilical cord mesenchymal stem cell preparation, containing 2.5×10\^7 cells; 2. medium-dose group: 100mL human umbilical cord mesenchymal stem cell preparation, containing 5.0×10\^7 cells; 3. High-dose group: 100mL human umbilical cord mesenchymal stem cell preparation, containing 1.0×10\^8 cells
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Aged between 18 and 65 (including 18 and 65), regardless of gender; * Decompensated stage of viral hepatitis B cirrhosis; * The effect of conventional medical treatment is not good, and the condition is repeated; * ALB \< 35g/L, TBIL \< 170μmol/L, INR \> 30%, Child-pugh score ≥7; MELD score ≤15; * Hgb \> 70g/L, PLT \> 3×109/L; * Unconditional acceptance for liver transplantation; 7）Participate in the clinical study voluntarily, cooperate with doctors to carry out the study, and sign informed consent.
Exclusion criteria
* With spontaneous peritonitis or other serious infection; * Patients with hepatorenal syndrome; * Severe hepatic encephalopathy, massive hemorrhage of digestive tract or varicose 4. vein in recent 1 month; * Portal vein thrombosis; Complicated with serious diseases of heart, lung, kidney, * blood and endocrine system; * HIV positive; * Positive autoantibodies related to autoimmune liver disease; * Presence of liver or any type of malignant tumor; * Pregnant women, breast-feeding women or those with recent birth plans; * Those who have a history of alcohol and drug abuse and failed to get rid of it effectively; * Participated in other clinical trials within 3 months prior to enrollment; * Participated in clinical research on stem cells; * Unwillingness to sign informed consent; * Other conditions that the investigator considers inappropriate for patients to participate in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Serum albumin in g/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Antithrombin in mg/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Prothrombin activity in percentage | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Serum cholesterol in mmol/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Direct bilirubin in μmol/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Total bilirubin in μmol/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| cholinesterase in U/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| aspartate aminotransferase in U/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| alanine aminotransferase in U/L | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Interleukin-1β cells in pg/mL | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Th2 cells in percentage | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Natural killer T cells in percentage | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Interleukin-4 cells in pg/mL | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Interleukin-6 cells in pg/mL | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Interleukin-8 cells in pg/mL | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Interleukin-12 cells in pg/mL | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Interleukin-15 cells in pg/mL | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Interleukin-17A cells in pg/mL | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Medical images | 24 weeks | Ultrasound in first day, 4th, 8th, 12th and 24th; enhanced CT scanning and/or MRI-Primovist scanning in first day, 12th week and 24th week. |
| The Medical outcomes study 36-item Short Form Health Survay scale (SF-36 scale) | 24 weeks | SF-36 scale is a measurement for patients' living quality. The scores contain 8 parts, including physical functioning, role-physica, bodily pain, general health, vitality, social functioning, role-emotional and mental health. Conversion score=(actual score-minimum score in this part)/(maximum score in this part-minimum score in this part)\*100. Score of each part range from 0 to 100. The higher score means more healthy. We proceed SF-36 test in 12th week and 24th week |
| MELD score | 24 weeks | MELD=3.78\*Ln(total bilirubin mg/dL)+11.2\*Ln(INR)+9.57\*Ln(serum creatine mg/dL)+6.43 (for HBV patient) We compare MELD score in first day, 4th, 8th, 12th and 24th week, to describe its tendency. |
| survival rate | 2 years | survival rate after 2 years since the first therapy |
| Child-Pugh grade | 24 weeks | Child-Pugh grade is defined according to hepatic encephalopathy, ascites，serum albumin, total bilirubin, prothrombin time. Score 5-6 is grade A. Score 7-9 is grade B. Score 10-15 is grade C. We compare the Child-Pugh grade in first day, 4th, 8th, 12th and 24th week, to describe its tendency. |
| Rate of weight change | 24 weeks | We compare the weight in first day, 4th, 8th, 12th and 24th week, to describe its tendency. |
| Ascites | 24 weeks | We test the ascites via ultrasound, CT and MRI. We classify the ascite level into none, low and high. We compare the Child-Pugh grade in first day, 4th, 8th, 12th and 24th week, to describe its tendency. |
| clinical symptoms | 24 weeks | Including lower limb edema, hematemesis, jaundice, fatigue, poor appetite. We compare these symptoms in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Th1 cells in percentage | 24 weeks | We compare this index in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Electrocardiogram of 12 leads | 24 weeks | Including lead I, II, III, AVL, AVF, AVR, V1 to V6. We record the diagnosis of the ECG, not a specific parameter. We test it in first day, 4th, 8th, 12th and 24th week. |
| Serum urea nitrogen in mmol/L | 24 weeks | We test it in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Serum creatine in μmol/L | 24 weeks | We test it in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Serum creatine in | 24 weeks | We test it in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Thrombocyte in 10^9/L | 24 weeks | We test it in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Hemoglobin in g/L | 24 weeks | We test it in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Leukocyte in 10^9/L | 24 weeks | We test it in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
| Physical examination | 24 weeks | Including jaundice in skin or sclera, liver palms, spider angioma, abdominal tenderness, borborygms, shifting dullness. We proceed the physical examination in first day, 1st , 2nd, 3rd, 4th, 8th, 12th and 24th week. |
| Vital signs | 24 weeks | body temperature, pulse, respiration, blood pressure. We measure the vital signs in first day, 1st , 2nd, 3rd, 4th, 8th, 12th and 24th week. |
| Adverse events | 24 weeks | Including infusion reaction, anaphylaxis, hemolysis, acute liver failure, acute kidney failure. We observe whether participants shows these adverse event during the first whole 2 weeks and 4th, 8th, 12th and 24th weeks |
| Alpha-fetoprotein in ng/mL | 24 weeks | We test it in first day, 4th, 8th, 12th and 24th week, to describe their tendency. |
Countries
China
Outcome results
None listed