Evaluation of Liver Regeneration With Autologous Peripheral Stem Cells

NCT ID: NCT01108380

Last Updated: 2010-12-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-01-31

Study Completion Date

2011-12-31

Brief Summary

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For patient with liver cirrhosis who need to right or extended right hepatectomy, we will treat with autologous peripheral stem cells transplantation to facilitate liver regeneration. We will asses liver regeneration by evaluation of liver volume and liver function test.

Detailed Description

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1. Patients: 30 patients (10 patients in each 3 group)
2. Indication:

* Patients with Primary hepatocellular carcinoma combined liver cirrhosis (Hepatitis B, C, Non-B Non-C)
* Planned to right hepatectomy or extended right hepatectomy
* Patients who need right portal vein embolization due to insufficient expected remnant liver volume (\< 40%) or severe hepatic dysfunction(ICGR15\>10%)
* Child A classification
* ICG R15 \< 25%
* Age : 20 - 70 years old
* Expected life period \> 3months
* The patients who agreed to this study.
3. Contraindication

* Patients who planned liver transplantation
* Age \<20 or \>70 years old
* Pregnant women
* Patients on acute infection
* Acute hepatic failure
* Child class B or C
* Heart failure
* Existence of bleeding tendency : platelet \< 30,000, INR \> 2.2, Cr \>2.5
* Patients who did not agree to this study.
4. Allocation: We will allocate patients randomly to three group including control group.
5. Methods

* Group 1: 4 days injection of G-CSF -\> Plasma pheresis, Selection of CD34 cell -\> Right portal vein embolization and infusion of CD34 cell into left portal vein.
* Group 2: 4 days injection of G-CSF -\> Plasma pheresis -\> Right portal vein embolization and infusion of mononuclear cell into left portal vein.
* Group 3 (control): Right portal vein embolization

( -\> after 4 weeks, operation will be performed)
6. Evaluation: Change of liver volume, liver function test before and after portal vein embolization

Conditions

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Liver Cirrhosis

Keywords

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Liver cirrhosis liver regeneration liver volume liver function hepatocellular carcinoma, extensive hepatectomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1. CD34

1. 4 days injection of G-CSF (10μg/kg, Subcutaneous infusion)
2. On 5th day, plasmapheresis will be performed to select mononuclear cells. (at least 4x10(9) of mononuclear cells)
3. CD 34 cells will be selected by CliniMACS (Miltenyi Biotec, Bergisch- Gladbach, Germany) (at least 1x10(7) of CD 34 cell)
4. In same day, right portal vein embolization with infusion of CD 34 cells into left portal vein will be performed.

Group Type EXPERIMENTAL

Plasma pheresis, Right portal vein embolization

Intervention Type PROCEDURE

Plasma pheresis : With insertin of 2 intravenous line, plasmapheresis will be done with COBE BCT Inc. It will be performed under supervision of clinical laboratorians and doctors.

Right portal vein : Under ultrasonography guided, left portal vein be punctured. Right portal vein will be embolized by coil or gelfoam.

2. Mononucelar cell

1. 4 days injection of G-CSF (10μg/kg, Subcutaneous infusion)
2. On 5th day, plasma pheresis will be performed to select mononuclear cells. (at least 4x10(9) of mononuclear cells)
3. In same day, right portal vein embolization with infusion of mononuclear cells into left portal vein will be performed.

Group Type ACTIVE_COMPARATOR

Plasma pheresis, Right portal vein embolization

Intervention Type PROCEDURE

Plasma pheresis : With insertin of 2 intravenous line, plasmapheresis will be done with COBE BCT Inc. It will be performed under supervision of clinical laboratorians and doctors.

Right portal vein : Under ultrasonography guided, left portal vein be punctured. Right portal vein will be embolized by coil or gelfoam.

3. Control

Without infusion of G-CSF, patients will be performed just right portal vein embolization

Group Type OTHER

Plasma pheresis, Right portal vein embolization

Intervention Type PROCEDURE

Plasma pheresis : With insertin of 2 intravenous line, plasmapheresis will be done with COBE BCT Inc. It will be performed under supervision of clinical laboratorians and doctors.

Right portal vein : Under ultrasonography guided, left portal vein be punctured. Right portal vein will be embolized by coil or gelfoam.

Interventions

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Plasma pheresis, Right portal vein embolization

Plasma pheresis : With insertin of 2 intravenous line, plasmapheresis will be done with COBE BCT Inc. It will be performed under supervision of clinical laboratorians and doctors.

Right portal vein : Under ultrasonography guided, left portal vein be punctured. Right portal vein will be embolized by coil or gelfoam.

Intervention Type PROCEDURE

Other Intervention Names

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COBE BCT Inc : for plasmapheresis

Eligibility Criteria

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Inclusion Criteria

1. Patients with Primary hepatocellular carcinoma combined liver cirrhosis (Hepatitis B, C, Non-B Non-C)
2. Planned to right hepatectomy or extended right hepatectomy
3. Patients who need right portal vein embolization due to unsufficient expected remnant liver volume (\< 40%) or severe hepatic dysfunction (ICG R15 \> 10%)
4. Child A classification
5. ICG R15 \< 25%
6. Age: 20 - 70 years old
7. Expected life period \> 3months
8. The patients who agreed to this study

Exclusion Criteria

1. Patients who planned liver transplantation
2. Age \< 20 or \> 70 years old
3. Pregnant women
4. Patients on acute infection
5. Acute hepatic failure
6. Child class B or C
7. Heart failure
8. Existence of bleeding tendency : platelet \< 30,000, INR \> 2.2, Cr \>2.5
9. Patients who did not agree to this study
Minimum Eligible Age

20 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Seoul National University Bundang Hospital

OTHER

Sponsor Role collaborator

Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Surgery department

Principal Investigators

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Ho-Seong Han, PhD

Role: PRINCIPAL_INVESTIGATOR

Chairman of surgery, Seoul National University Bundang Hospital

Locations

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Ho-Seong Han

Seongnam-si, Gyeonggi-do, South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Ho-Seong Han, PhD

Role: CONTACT

Phone: 82-31-787-7099

Email: [email protected]

Keun Soo Ahn, MD

Role: CONTACT

Phone: 82-31-787-7099

Email: [email protected]

Other Identifiers

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B-0901-068-003

Identifier Type: OTHER

Identifier Source: secondary_id

SNUBH-GS-HBP3

Identifier Type: -

Identifier Source: org_study_id