Human Amniotic Membrane and Mesenchymal Stem Cells Composite

NCT ID: NCT04654286

Last Updated: 2020-12-07

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

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-17

Study Completion Date

2022-07-30

Brief Summary

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The purpose of this clinical trial is to investigate the utility of composite wrapping comprising human amniotic membrane and allogeneic adipose-derived mesenchymal stem cells (HAM-AdMSC) for augmentation of nerve transfer procedure in upper TBPI patients

Detailed Description

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Nerve transfer procedure is recognized as the current gold standard for treating traumatic brachial plexus injury (TBPI). However, despite the current major progress in diagnosis and microsurgical repair, the prognosis in TBPI remains unfavorable due to limited donor nerve and compromised regenerative capability of the nervous system arising from prolonged denervation. Therefore, there is a major need to devise new treatment strategies; and one possible approach is to develop cellular therapies to bioengineer new nerve tissue and/or modulate the endogenous regenerative mechanisms within the injured nerve.

Our previous studies have shown that the peripheral nerve tissue engineering approach using human amniotic membrane seeded with allogeneic adipose-derived MSCs to augment axonal regeneration in nerve transfer of TBPI patient revealed promising functional recovery of the shoulder range of motion (ROM). The investigators plan a non-randomized clinical trial in a single center to investigate the use of a hybrid (composite) between human amniotic membrane (HAM) and allogeneic adipose-derived mesenchymal stem cells (AdMSC) as wrapping in the nerve transfer procedure of upper TBPI patients, with a focus on the augmentation of axonal regeneration

Conditions

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Brachial Plexus Neuropathies

Keywords

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Brachial Plexus Injury Amniotic Membrane Mesenchymal Stem Cells Nerve Transfer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control group (Nerve transfer procedure)

Patient will receive nerve transfer procedure without augmentation

Group Type ACTIVE_COMPARATOR

Nerve transfer procedure

Intervention Type PROCEDURE

1. Identification of potential donor nerves: phrenic nerve, accessory nerve, intercostal nerve, motor branch nerve innervating long head of triceps muscle, motor branch of ulnar nerve innervating flexor carpi ulnaris (FCU) muscle, and motor branch of median nerve innervating flexor carpi radialis (FCR) muscle.
2. Donor nerve is checked for its viability with an electric stimulator during surgery
3. Viable donor nerve is dissected, transferred to the recipient area, and sutured with end-to-end anastomosis.

Experimental group (Nerve transfer with HAM-AdMSC composite wrapping)

Following nerve transfer procedure, the end-to-end anastomosis will be wrapped with HAM-AdMSC composite as augmentation

Group Type EXPERIMENTAL

Nerve transfer with HAM-AdMSC composite wrapping

Intervention Type PROCEDURE

When the nerve transfer procedure is finished, the end-to-end anastomosis is wrapped by a composite consisted of human amniotic membrane and allogeneic adipose-derived mesenchymal stem cells (HAM-AdMSC)

Interventions

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Nerve transfer procedure

1. Identification of potential donor nerves: phrenic nerve, accessory nerve, intercostal nerve, motor branch nerve innervating long head of triceps muscle, motor branch of ulnar nerve innervating flexor carpi ulnaris (FCU) muscle, and motor branch of median nerve innervating flexor carpi radialis (FCR) muscle.
2. Donor nerve is checked for its viability with an electric stimulator during surgery
3. Viable donor nerve is dissected, transferred to the recipient area, and sutured with end-to-end anastomosis.

Intervention Type PROCEDURE

Nerve transfer with HAM-AdMSC composite wrapping

When the nerve transfer procedure is finished, the end-to-end anastomosis is wrapped by a composite consisted of human amniotic membrane and allogeneic adipose-derived mesenchymal stem cells (HAM-AdMSC)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Suffering from upper BPI (C5-C6 and/or C5-C7) for a duration of fewer than 12 months
* Have no systemic disease (Diabetes Mellitus, Lupus erythematosus, rheumatoid arthritis)
* Without prior medicamentous treatment history such as corticosteroids
* Agree to contribute in the study

Exclusion Criteria

* Complete BPI (C5-Th1), lower BPI (C8-Th1)
* Traumatic BPI associated with delayed/non-union fracture of the upper extremity affected side.
* Polytrauma conditions which are not fully recovered
Minimum Eligible Age

15 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Dr. Soetomo General Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Heri Suroto, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Dr. Soetomo General Academic Hospital/ Universitas Airlangga

Locations

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Cell and Tissue Bank - Regenerative Medicine, Dr. Soetomo General Academic Hospital/ Faculty of Medicine Universitas Airlangga

Surabaya, East Java, Indonesia

Site Status RECRUITING

Countries

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Indonesia

Central Contacts

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Heri Suroto, MD,PhD

Role: CONTACT

Email: [email protected]

Heri Suroto, MD,PhD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Heri Suroto, MD, PhD

Role: primary

Heri Suroto, MD, PhD

Role: backup

Other Identifiers

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647 / Panke.KKE/ XI / 2016

Identifier Type: -

Identifier Source: org_study_id