Intra-hepatic Artery Bone Marrow Derived Stem Cells Infusion for the Treatment of Advanced Liver Cirrhosis

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. Identifier: NCT01412593
Recruitment Status : Unknown
Verified May 2011 by King Saud University.
Recruitment status was:  Not yet recruiting
First Posted : August 9, 2011
Last Update Posted : August 9, 2011
Information provided by:
King Saud University

August 8, 2011
August 9, 2011
August 9, 2011
September 2011
September 2012   (Final data collection date for primary outcome measure)
Improvement of liver function measured by improvement in the model for end-stage liver disease (MELD) score. [ Time Frame: 2 years ]
Same as current
No Changes Posted
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Intra-hepatic Artery Bone Marrow Derived Stem Cells Infusion for the Treatment of Advanced Liver Cirrhosis
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Liver disease is a common medical problem in Saudi Arabia. Early studies indicated that around 10% of the Saudi population is either infected with hepatitis B or C. An estimated 12% of chronic HCV and HBV patients undergoing liver biopsy from Saudi centers have cirrhosis. Of these 3-5% would decompensate yearly thereby requiring liver transplantation. Based on the most recent national census figures, and a 1-2% prevalence rate of HBV and HCV nationwide, an estimated 1,000 patients would require liver transplantation on a yearly basis for decompensated cirrhosis.

Liver transplantation is the only available life saving treatment for patients with end stage liver disease. Unfortunately less than 100 liver transplantations are performed in Saudi Arabia in three centers. Around 100 other patients travel abroad for transplantation annually while all other patients progressively deteriorate and eventually die from the complications of decompensated liver cirrhosis.

In addition, even in patients who are listed for liver transplantation, often patients are too sick to wait on the transplant list that often takes more than a year and the on-list mortality is high. A procedure or an intervention that may help to stabilize liver function in order to help patients survive on the transplant list while awaiting liver transplantation would be of immense benefit. Examples of such interventions are already approved and used in some centers like the MARS system.

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Phase 1
Phase 2
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
End Stage Liver Disease
Biological: Stem cell transplant
Patients randomized to the intervention arm will be admitted to the Liver Care Unit. Granulocyte colony-stimulating factor (G-CSF; 300mcg/mL) will be administered for 1 day as a single daily subcutaneous dose. This dose is sufficient to induce 10 folds enrichment for bone marrow cells.
  • Experimental: Stem cell transplant
    Intervention: Biological: Stem cell transplant
  • No Intervention: Control
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*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Unknown status
September 2013
September 2012   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Age >18 years
  • Clinically diagnosed liver cirrhosis by any of the following: ultrasound/MRI/ CT/ + tissue biopsy.
  • MELD score ≥ 18 and <35
  • Ability to sign an informed consent
  • Refused by liver transplant program or labeled as not a liver transplant candidate, decided by at least 3 transplant physicians

Exclusion Criteria:

  • On a liver transplantation waiting list
  • Questionable diagnosis of cirrhosis
  • Prior history of organ transplantation
  • Past history of malignancy within the 2 years prior to inclusion
  • Probable or diagnosis of hepatocellular carcinoma
  • Major hepatic vascular thrombosis (hepatic artery, or portal or hepatic veins)
  • Serious cardiovascular or respiratory disease, or other medical condition with a high anticipated mortality within twelve months
  • Current or recent (within the past 4 weeks) use of vasoactive drugs (Epinephrine, Norepinephrine, Vasopressin, Dopamine, terlipressin)
  • Type-1 (acute) hepatorenal syndrome
  • Levels of serum creatinine >150 µmol/ml and/or creatinine clearance <30 ml/min (as calculated by MDRD system)
  • Documented or suspected ongoing infection
  • Active or recent gastrointestinal bleeding episode (in the previous 4 weeks)
  • Active alcohol abuse extending to within the previous six months
  • Pulmonary hypertension (PAP > 35 mmHg), porto-pulmonary hypertension or hepatopulmonary syndrome
  • Pregnancy
  • HIV infection
  • Active or past drug addiction within the preceding 6 months
  • History of serious or uncontrolled psychiatric disease or depression
  • Contraindications to the angiography procedures (e.g. arterial aneurysm, kinking, thrombosis)
  • Contraindications for bone marrow biopsy (e.g. bleeding diathesis)
  • Prior shunt operative shunt procedure
Sexes Eligible for Study: All
18 Years to 75 Years   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
Saudi Arabia
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Dr Ayman Abdo, King Saud University
King Saud University
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King Saud University
May 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP