Clinical trial NCT01856049: Umbilical Cord Blood Collection and Processing for Hypoplastic Left Heart Syndrome Patients
Official title: Umbilical Cord Blood Collection and Processing for Severe Congenital Heart Disease
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hypoplastic Left Heart Syndrome (HLHS)
Keywords: HLHS
Hypoplastic Left Heart Syndrome
UCB (umbilical cord blood)
Umbilical cord blood
Cord blood
Cardiac regeneration
Lead sponsor: Mayo Clinic
Sponsor class: OTHER
First posted: 2013-05-17
Enrollment: 464
Sex: FEMALE
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: BASIC_SCIENCE

Brief summary: Cell-based cardiac regeneration has been the focus of acquired, adult heart disease for many years. However, congenital heart disease with severe structural abnormalities may also be reasonable targets for cell-based therapies. Interestingly, the pediatric heart is naturally growing and may be the most amendable to regenerative strategies. Therefore, identifying autologous cells (cells from the patient's own body) would be important to initiate these studies.

This study aims to validate the use of umbilical cord blood as a source of autologous cells for the purpose of cardiac repair of congenital heart disease. Cells will be isolated from the cord blood to help us determine the feasibility of collection, processing, and storage of these samples at the time of birth of infants with prenatal diagnosis of hypoplastic left heart syndrome. This study may be useful for the development of pre-clinical and clinical studies aimed at the long-term goal of repairing damaged heart muscle.

Detailed description: Congenital heart disease (CHD) is an abnormal formation that occurs during the development of a baby's heart, heart valves and/or large vessels such as the aorta artery. CHD is the most common cause of major congenital defects accounting for almost 30% of all defects. While the statistics vary among studies, the best birth prevalence estimate is 8 per 1000 live births. In the USA, CHD affects 1% of all births per year, with an estimated 40,000 babies born with any type of heart defect every year.

The important improvements in CHD diagnosis and surgical treatment in the last decades has led to an increased survival of newborns affected with heart defects. A large number of CHD can be diagnosed during pregnancy, and the patients can present a broad range of symptoms. Forms of CHD are usually classified based on their severity, from mild to severe. One of the mildest forms of CHD is atrial septal defect, which can be undetectable until adulthood and VSD. On the other hand, severe CHD that requires multiple palliative surgeries includes single ventricle defects, such as hypoplastic left heart syndrome (HLHS), and tricuspid atresia.

The survival of infants with CHD will depend on the severity of the defect and the time of diagnosis and treatment received. The one-year survival of newborns with severe or critical CHD (generally any type of surgery/procedures in their first year of life) is estimated to be 75%.

Stem cell therapy has emerged as a new paradigm of treatment in the field of CHD with promising results. Cardiac regeneration has been the focus of acquired, adult heart disease for many years. However, congenital heart disease with structural abnormalities may also be a good target for other research studies. In fact, the pediatric heart is naturally growing and may be amendable to regenerative strategies. Furthermore, the initial pre-clinical and clinical studies have demonstrated that the delivery of stem cells into the heart of patients with CHD is feasible and safe. Moreover, the cell therapy approach, along with the standard surgical palliation, seems to offer benefits over surgical treatment alone. Even though the number of cell therapy clinical trials for CHD has increased in the last decade, more long-term follow-up studies are needed in this population setting in order to define the role of stem cell therapy in the clinical practice. Therefore, confirming our ability to produce autologous cells (cells from the patient's own body) from patients with severe CHD is an important step towards the long-term goal of being able to discover innovative cell-based protocols.

Eligibility criteria: Inclusion Criteria:

* Any pregnant woman, regardless of age, with a prenatal diagnosis of severe CHD/hypoplastic left heart syndrome.
* One or both parents willing to consent to the storage of umbilical cord blood for the specific purpose of regenerative research
* Delivering party and/or expectant family is willing to sign Release of Information to request fetal echo text report diagnosing severe CHD/hypoplastic left heart syndrome
* Parent(s) willing to be contacted 60 days after collection for follow-up screening questions regarding the health status of the baby affected with severe CHD/hypoplastic left heart syndrome.

Exclusion Criteria:

* Individuals unwilling to participate

Primary outcomes:
measure: Percent of samples contaminated
timeFrame: 14 days after collection
measure: Percent of cells that are viable following post thaw analysis
timeFrame: 5 years
Secondary outcomes:
Other outcomes:
Locations:
city: Rochester
country: United States
facility: Mayo Clinic
state: Minnesota
city: Philadelphia
country: United States
facility: Children's Hospital of Philadelphia
state: Pennsylvania
Study officials:
affiliation: Mayo Clinic
name: Susana Cantero Peral, M.D., Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: