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Mesenchymal Stem Cell Transplantation in Decompensated Cirrhosis

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified February 2009 by University of Tehran.
Recruitment status was:  Active, not recruiting
Sponsor:
ClinicalTrials.gov Identifier:
NCT00476060
First Posted: May 21, 2007
Last Update Posted: January 11, 2011
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by:
University of Tehran
  Purpose
The standard treatment for decompensated cirrhosis is liver transplantation, however, it has several limitations. Recent animal studies suggest that bone marrow stem cell transplantation can lead to regression of liver fibrosis. The investigators have already completed the phase 1 study of bone marrow mesenchymal stem cell (MSC) transplantation in 4 patients with cirrhosis. The procedure was safe, and feasible, and led to somewhat promising results (Mohamadnejad M, et al. 2006; Submitted for publication). The aim of this study is to find efficacy of this new treatment strategy in the setting of a multicenter, randomized placebo-controlled trial in 50 patients with decompensated cirrhosis.

Condition Intervention Phase
Cirrhosis Procedure: Autologous mesenchymal stem cell transplantation Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Autologous Mesenchymal Stem Cell Transplantation in Patients With Decompensated Cirrhosis: A Randomized Placebo-controlled Trial

Resource links provided by NLM:


Further study details as provided by University of Tehran:

Primary Outcome Measures:
  • MELD score, quality of life, liver volume, histological improvement (In a subset of patients with evidences of clinical and biochemical improvement, follow up liver biopsy will be performed at the end of follow up). [ Time Frame: One year ]

Secondary Outcome Measures:
  • All cause mortality, tracking the infused cells in the patients' bodies. [ Time Frame: One year ]

Estimated Enrollment: 36
Study Start Date: January 2007
Estimated Study Completion Date: August 2011
Estimated Primary Completion Date: August 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: A Procedure: Autologous mesenchymal stem cell transplantation
Arm A: 300 million cells will be infused one time through a peripheral vein/// Arm B: Infusion of placebo one time through a peripheral vein
Placebo Comparator: B Procedure: Autologous mesenchymal stem cell transplantation
Arm A: 300 million cells will be infused one time through a peripheral vein/// Arm B: Infusion of placebo one time through a peripheral vein

Detailed Description:
The standard treatment for decompensated cirrhosis is liver transplantation, however, it has several limitations, including small donor pool, long waiting list, and several complications. Recent animal studies suggest that bone marrow stem cell transplantation can lead to regression of liver fibrosis. The investigators have already completed the phase 1 study of bone marrow mesenchymal stem cell (MSC) transplantation in 4 patients with cirrhosis. The procedure was safe, and feasible, and led to somewhat promising results (Mohamadnejad M, et al. 2006; Submitted for publication). The aim of this study is to find efficacy of this new treatment strategy in the setting of a multicenter, randomized placebo controlled trial. After assignment of the written informed consent, thirty six patients with decompensated cirrhosis will be enrolled, and will be randomized by block randomization into treatment or placebo arm. All the enrolled patients will be in the waiting list of liver transplantation. In the treatment arm bone marrow of the patients will be aspirated, and autologous bone marrow mesenchymal stem cells will be cultured, and then will be infused through a peripheral vein. Also, the corresponding placebo will be infused for the placebo group. The patients will be followed up for 1 year after performing the procedure.
  Eligibility

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Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Cirrhosis (diagnosed by clinical, biochemical, sonographic, and histologic evidences of cirrhosis) (Patients will have histological documentation of cirrhosis before enrollment. However, for those with evidences of severe coagulopathy liver biopsy may not be performed)
  • Evidences of decompensated liver disease at screening (e.g. child class B, or C)

Exclusion Criteria:

  • Presence of active hepatic encephalopathy
  • Refractory ascites
  • Evidences of active autoimmune liver disease (e.g. gamma globulin of more than 2 times of upper limit of normal, and ALT > 3 times normal in patients with autoimmune hepatitis)
  • Hepatocellular carcinoma or other malignancies
  • Active infectious disease
  • Presences of severe underlying cardiac, pulmonary, or renal disease
  • Alcohol use in the last 3 months before screening
  • Use of hepatotoxic drugs in the last 3 months before screening
  • Unwilling to assign the informed consent
  • Presence of significant extrahepatic biliary disease (e.g. CBD stone, PSC, etc.)
  • Positive HIV ab
  • Positive HBsAg with detectable HBV DNA PCR
  • Positive HCV Ab with detectable HCV RNA PCR
  • Active thrombosis of the portal or hepatic veins
  • Serum Cr > 1.8 mg/dL at screening
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00476060


Locations
Iran, Islamic Republic of
Digestive Disease Research Center, Shariati Hospital
Tehran, Iran, Islamic Republic of, 14117-13135
Sponsors and Collaborators
University of Tehran
Investigators
Study Chair: Reza Malekzadeh, M.D Digestive Disease Research Center, Medical Sciences/ University of Tehran
Study Chair: Ardeshir Ghavamzadeh, M.D. Hematology, Oncology, and BMT research center, Medical Sciences/University of Tehran
Principal Investigator: Mehdi Mohamadnejad, M.D. Digestive Disease Research Center, Medical Scineces/ University of Tehran
Principal Investigator: Kamran Alimoghaddam, M.D. Hematology, Oncology, and BMT research center, Medical Sciences/University of Tehran
  More Information

Responsible Party: Reza Malekzadeh, Digestive Disease Research Center, Medical Sciences/ University of Tehran
ClinicalTrials.gov Identifier: NCT00476060     History of Changes
Other Study ID Numbers: DDRC85-13
First Submitted: May 16, 2007
First Posted: May 21, 2007
Last Update Posted: January 11, 2011
Last Verified: February 2009

Keywords provided by University of Tehran:
Cirrhosis
Bone marrow
Mesenchymal stem cell
MELD score
Quality of life

Additional relevant MeSH terms:
Fibrosis
Liver Cirrhosis
Pathologic Processes
Liver Diseases
Digestive System Diseases