Hypoplastic Left Heart SyndromePhase 2NCT03779711
Intramyocardial Injection of Autologous Umbilical Cord Blood Derived Mononuclear Cells During Surgical Repair of Hypoplastic Left Heart Syndrome
A Phase 2 study testing Autologous (self) mononuclear cells derived from umbilical cord blood and Stage II Surgical repair in people with Hypoplastic Left Heart Syndrome, run by Timothy J Nelson, MD, PhD at 8 sites in United States.
Trial summary
Researchers want to better understand what happens to the heart when the stem cells are injected directly into the muscle of the right side of the heart during the Stage II palliative surgery for single ventricle patients with hypoplastic left heart syndrome (HLHS) or HLHS variant. Read more about this study
- Who is it for?
- Ages Up to 12 months
- Conditions the study is for
- Hypoplastic Left Heart Syndrome
- What is being tested?
- Autologous (self) mononuclear cells derived from umbilical cord blood and Stage II Surgical repair
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 95 participants
- Where
- 8 sitesUnited States
- Study dates
- 6 Jun 2019to Feb 2026
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 12 months
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Diagnosis of HLHS or HLHS variant with single right ventricular dependent CHD having undergone Stage I surgical repair and undergoing Stage II surgical repair.
- Less than 13 months of age at time of Stage II surgical repair
- Previous participation in the UCB collection protocol with autologous UCB-MNC product that is acceptable for use (treatment arm only)
Who cannot join
- History of DMSO reaction (treatment arm only).
- Parent(s) and/or legal guardian(s) unwilling to have their child participate or unwilling to follow the study procedures.
- Severe chronic diseases at the discretion of the treating physician.
- Extensive extra-cardiac syndromic features.
- Known history of cancer.
- Any of the following complications of his/her congenital heart disease:
Show all 9Show fewer
- Any condition requiring urgent, or unplanned interventional procedure within 15 days prior to Stage II surgical repair, unless complete and full cardiac recovery is documented by site investigator
- Severe pulmonary hypertension (reported in the medical record as >70% systemic pressure)
- Other clinical concerns as documented by a site investigator that would predict (more likely to happen than not to happen) a risk of severe complications or very poor outcome, not directly related to the stem cell product or its injection procedure, during or after Stage II surgical repair.
Trial locations and contacts
8 sites in 1 country.
8 sites in 1 country
United States8 sites
Children's Hospital Colorado
Aurora, Colorado, 80045
Children's of Alabama
Birmingham, Alabama, 35233
Cincinnati Children's Hospital and Medical Center
Cincinnati, Ohio, 45529
Children's Hospital of Los Angeles
Los Angeles, California, 90027
Children's Hospitals of Minnesota
Minneapolis, Minnesota, 55404
Ocshner Medical Center
New Orleans, Louisiana, 70121
Oklahoma University Medical Center
Oklahoma City, Oklahoma, 73104
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
About this study
Official title: Phase IIb Study of Intramyocardial Injection of Autologous Umbilical Cord Blood Derived Mononuclear Cells During Stage II Surgical Repair of Right Ventricular Dependent Variants of Hypoplastic Left Heart Syndrome (AutoCell-S2)
Researchers want to better understand what happens to the heart when the stem cells are injected directly into the muscle of the right side of the heart during the Stage II palliative surgery for single ventricle patients with hypoplastic left heart syndrome (HLHS) or HLHS variant. Researchers want to see if there are changes in the heart's structure/function following this stem cell-based therapy and compared to children that have not had cell-based therapy.
Read the detailed description
This is a Phase IIb trial to determine if the delivery of the autologous UCB-MNC product into the myocardium of the right ventricle of the heart at the time of Stage II surgical repair will provide an improvement in cardiac function, reaching growth and developmental milestones, and quality of life, while also providing a reduction in the cumulative days of hospitalization following Stage II surgical repair. Long-term improvement in cardiac function, reaching growth and developmental milestones, reaching Stage III surgical repair pre-op work-up, prolonging time to cardiac transplantation or death, and improving quality of life will also be determined.
- Conditions
- Hypoplastic Left Heart Syndrome
- Being tested
- Autologous (self) mononuclear cells derived from umbilical cord blood, Stage II Surgical repair
- Keywords
- Hypoplastic Left Heart Syndrome, HLHS, Congenital Heart Disease, Umbilical Cord Blood, UCB, Cord blood, Stem cells, Regenerative therapy, Stage II Glenn, Glenn Surgery, single ventricle
- Medical subject headings
- Hypoplastic Left Heart Syndrome, Heart Defects, Congenital, Univentricular Heart
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Autologous (self) mononuclear cells derived from umbilical cord bloodBiological
The investigational product will be delivered into the right myocardium via sub-epicardial injections of 0.1 mL per kg body weight to achieve the target dose of 1-3 million TNC per kg body weight.at the time of Stage II surgical repair.
Stage II Surgical repairProcedure or surgery
This operation usually is performed about six months after Stage I surgery to divert half of the blood to the lungs when circulation through the lungs no longer needs as much pressure from the ventricle. The shunt to the pulmonary arteries is disconnected and the right pulmonary artery is connected directly to the superior vena cava, the vein that brings deoxygenated blood from the upper part of the body to the heart. This sends half of the deoxygenated blood directly to the lungs without going through the ventricle.
| Study group | Role | What they receive |
|---|---|---|
| Treatment | Experimental | Autologous (self) mononuclear cells derived from umbilical cord blood and that meet all release criteria are injected into the surface of the right heart muscle to achieve the target dose of 1-3 million cells per kilogram body weight . This is a one time treatment at the time of Stage II Glenn surgery . Receives: Biological: Autologous (self) mononuclear cells derived from umbilical cord blood; Procedure: Stage II Surgical repair |
| Control | Active comparator | Clinical data will be collected before, during and after the Stage II surgical standard of care procedure. Requires additional imaging studies at 3 months that are not standard of care in addition to some blood tests that would be beyond standard of care. Information will be collected to document the clinical outcomes and will be compared with the information from the group receiving the investigational treatment used in this study. Receives: Procedure: Stage II Surgical repair |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Right ventricular cardiac function as measured by echocardiogram that includes studies for apical fractional area change (FAC). Measured by percent.
Measured: baseline, 3 months post-Stage II surgery
Change in Right Ventricular Cardiac Function Measured by Circumferential Strain.
Right ventricular cardiac function as measured by echocardiogram that includes studies for circumferential strain. Measured by percent.
Measured: baseline, 3 months post-Stage II surgery
Change in Right Ventricular Cardiac Function Measured by Longitudinal Strain.
Right ventricular cardiac function as measured by echocardiogram that includes studies for longitudinal strain. Measured by percent.
Measured: baseline, 3 months post-Stage II surgery
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Right ventricular cardiac function as measured by echocardiogram that includes studies for apical fractional area change (FAC). Measured by percent.
Measured: baseline, 12 months post-Stage II surgery
Secondary outcomes (12)
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Right ventricular cardiac function as measured by echocardiogram that includes studies for apical fractional area change (FAC). Measured by percent.
Measured: baseline pre-op, hospital discharge from Stage II surgery (an average of 1-6 weeks)
Cumulative Days of Hospitalization
Cumulative days of hospitalization per patient following discharge for the Stage II surgical repair.
Measured: 1-month post Stage II surgery
Change in Weight
Change in weight between baseline and 3-months post Stage II surgery. Weight as measured by scale provided as part of standard of care by subject's provider. Measured at home by subject's caregiver using the same scale for every home measurement of body weight. Caregivers will be instructed by the site to use the same scale for every home measurement of body weight. Scales will vary based on the institution's standard name/type used.
Measured: baseline, 3-months post Stage II surgery
Change in Heart Rate
Change in heart rate between baseline and 3-months post Stage II surgery. Heart rate as measured at home by subject's caregiver as standard of care per subject's provider. Caregivers will be instructed by the site staff on the best way to perform.
Measured: baseline, 3-months post Stage II surgery
Change in Oxygen Saturation
Change in oxygen saturation between baseline and 3-months post Stage II surgery. Oxygen saturation as measured at home by subject's caregiver using the pulse oximetry device provided as standard of care by subject's provider. Caregivers will be instructed by the site to use the same pulse oximetry device for every home measurement of oxygen saturation.
Measured: baseline, 3-months post Stage II surgery
Change in Weight
Weight as measured by scale provided as part of standard of care by subject's provider. Measured at home by subject's caregiver using the same scale for every home measurement of body weight. Caregivers will be instructed by the site to use the same scale for every home measurement of body weight. Scales will vary based on the institution's standard name/type used.
Measured: baseline, every 6 months post-Stage II surgery
Change in Arrhythmia and Heart Failure Medication
Changes in arrhythmia and heart failure medications will be recorded by caregiver on the concomitant medication diary throughout the subject's participation in the study starting at the time of consent.
Measured: 3-months post-surgery
Stage III Surgical Repair
The number of research subjects eligible for Stage III surgical repair
Measured: Stage III surgery pre-op, approx. 4 years
Total Time Until Listed for Cardiac Transplantation
The number of days between Stage II surgery and listed on cardiac transplantation list.
Measured: up to Stage III surgery pre-op, approx. 4 years
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Right ventricular cardiac function as measured by echocardiogram that includes studies for apical fractional area change (FAC). Measured by percent.
Measured: baseline, Stage III surgery pre-op
Total Time Until Death
The number of days between Stage II surgery and death occurrence
Measured: approx 4 years
Cumulative Days of Hospitalization
Cumulative days of hospitalization per patient following discharge for the Stage II surgical repair.
Measured: 3-months post Stage II surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Dec 2018
- Study start6 Jun 2019
- Primary completion22 May 2022
- Study completionFeb 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Hypoplastic Left Heart SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 95 participants (actual)
Sponsor and investigators
- Lead sponsor
- Timothy J Nelson, MD, PhD
- Sponsor type
- University, hospital or other
- Collaborators
- University of Oklahoma, Children's Hospital of Philadelphia, Children's Hospital Los Angeles, Children's Hospital Colorado, Children's Hospitals and Clinics of Minnesota, Ochsner Health System, Children's of Alabama, Children's Hospital Medical Center, Cincinnati
- Responsible party
- Sponsor-investigator, Timothy J Nelson, MD, PhD, ReGen Theranostics, Inc.
- Investigators
- Frank Cetta, MD, Principal investigator, Mayo ClinicHarold M. Burkhart, M.D., Principal investigator, Children's Hospital Oklahoma University Medical CenterJoseph W. Rossano, M.D., Principal investigator, Children's Hospital of PhiladelphiaDavid M. Overman, M.D., Principal investigator, Children's MinnesotaRam Kumar Subramanyan, M.D., Ph.D., Principal investigator, Children's Hospital Los AngelesJames Jaggers, M.D., Principal investigator, Children's Hospital ColoradoBenjamin Peeler, M.D., Principal investigator, Ochsner Health SystemWaldemar Carlo, M.D., Principal investigator, University of Alabama at Birmingham
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03779711
- Sponsor's protocol ID
- 18-004753
- Status last verified
- Jun 2025
- First submitted
- 4 Dec 2018
- Last updated
- 8 Jul 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Gallego-Navarro C, Jaggers J, Burkhart HM, Carlo WF, Morales DL, Qureshi MY, Rossano JW, Hagen CE, Seisler DK, Peral SC, Nelson TJ. Autologous umbilical cord blood mononuclear cell therapy for hypoplastic left heart syndrome: a nonrandomized control trial of the efficacy and safety of intramyocardial injections. Stem Cell Res Ther. 2025 May 1;16(1):215. doi: 10.1186/s13287-025-04316-3.
PubMed 40312733
Study at a glance
From the registry record, last updated by the sponsor on 8 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase IIb Study of Intramyocardial Injection of Autologous Umbilical Cord Blood Derived Mononuclear Cells During Stage II Surgical Repair of Right Ventricular Dependent Variants of Hypoplastic Left Heart Syndrome (AutoCell-S2)
- ClinicalTrials.gov ID
- NCT03779711
- Acronym / sponsor ID
- 18-004753
- Conditions
- Hypoplastic Left Heart Syndrome
- Keywords
- Hypoplastic Left Heart Syndrome, HLHS, Congenital Heart Disease, Umbilical Cord Blood, UCB, Cord blood, Stem cells, Regenerative therapy
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 95 participants (actual)
- Lead sponsor
- Timothy J Nelson, MD, PhDUniversity, hospital or other
- Collaborators
- University of Oklahoma, Children's Hospital of Philadelphia, Children's Hospital Los Angeles, Children's Hospital Colorado, Children's Hospitals and Clinics of Minnesota, Ochsner Health System, Children's of Alabama, Children's Hospital Medical Center, Cincinnati
- Study start
- 6 Jun 2019 (actual)
- Primary completion
- 22 May 2022 (actual)
- Study completion
- Feb 2026 (estimated)
- First posted
- 19 Dec 2018 (actual)
- Results
- Posted 8 Jul 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Researchers want to better understand what happens to the heart when the stem cells are injected directly into the muscle of the right side of the heart during the Stage II palliative surgery for single ventricle patients with hypoplastic left heart syndrome (HLHS) or HLHS variant. Researchers want to see if there are changes in the heart's structure/function following this stem cell-based therapy and compared to children that have not had cell-based therapy.
Detailed description
This is a Phase IIb trial to determine if the delivery of the autologous UCB-MNC product into the myocardium of the right ventricle of the heart at the time of Stage II surgical repair will provide an improvement in cardiac function, reaching growth and developmental milestones, and quality of life, while also providing a reduction in the cumulative days of hospitalization following Stage II surgical repair. Long-term improvement in cardiac function, reaching growth and developmental milestones, reaching Stage III surgical repair pre-op work-up, prolonging time to cardiac transplantation or death, and improving quality of life will also be determined.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Treatment | Experimental | Biological: Autologous (self) mononuclear cells derived from umbilical cord blood, Procedure: Stage II Surgical repairAutologous (self) mononuclear cells derived from umbilical cord blood and that meet all release criteria are injected into the surface of the right heart muscle to achieve the target dose of 1-3 million cells per kilogram body weight . This is a one time treatment at the time of Stage II Glenn surgery . |
| Control | Active comparator | Procedure: Stage II Surgical repairClinical data will be collected before, during and after the Stage II surgical standard of care procedure. Requires additional imaging studies at 3 months that are not standard of care in addition to some blood tests that would be beyond standard of care. Information will be collected to document the clinical outcomes and will be compared with the information from the group receiving the investigational treatment used in this study. |
Who may qualify
- Ages
- Up to 12 months
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- Diagnosis of HLHS or HLHS variant with single right ventricular dependent CHD having undergone Stage I surgical repair and undergoing Stage II surgical repair.
- Less than 13 months of age at time of Stage II surgical repair
- Previous participation in the UCB collection protocol with autologous UCB-MNC product that is acceptable for use (treatment arm only)
Key exclusion criteria (9 listed)
- History of DMSO reaction (treatment arm only).
- Parent(s) and/or legal guardian(s) unwilling to have their child participate or unwilling to follow the study procedures.
- Severe chronic diseases at the discretion of the treating physician.
- Extensive extra-cardiac syndromic features.
- Known history of cancer.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Autologous (self) mononuclear cells derived from umbilical cord bloodThe investigational product will be delivered into the right myocardium via sub-epicardial injections of 0.1 mL per kg body weight to achieve the target dose of 1-3 million TNC per kg body weight.at the time of Stage II surgical repair. | Biological | Treatment |
| Stage II Surgical repairThis operation usually is performed about six months after Stage I surgery to divert half of the blood to the lungs when circulation through the lungs no longer needs as much pressure from the ventricle. The shunt to the pulmonary arteries is disconnected and the right pulmonary artery is connected directly to the superior vena cava, the vein that brings deoxygenated blood from the upper part of the body to the heart. This sends half of the deoxygenated blood directly to the lungs without going through the ventricle. | Procedure or surgery | Control, Treatment |
Primary outcome
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Time frame: baseline, 3 months post-Stage II surgery
Right ventricular cardiac function as measured by echocardiogram that includes studies for apical fractional area change (FAC). Measured by percent.
Change in Right Ventricular Cardiac Function Measured by Circumferential Strain.
Time frame: baseline, 3 months post-Stage II surgery
Right ventricular cardiac function as measured by echocardiogram that includes studies for circumferential strain. Measured by percent.
Change in Right Ventricular Cardiac Function Measured by Longitudinal Strain.
Time frame: baseline, 3 months post-Stage II surgery
Right ventricular cardiac function as measured by echocardiogram that includes studies for longitudinal strain. Measured by percent.
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Time frame: baseline, 12 months post-Stage II surgery
Right ventricular cardiac function as measured by echocardiogram that includes studies for apical fractional area change (FAC). Measured by percent.
12 secondary outcomes
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Time frame: baseline pre-op, hospital discharge from Stage II surgery (an average of 1-6 weeks)
Cumulative Days of Hospitalization
Time frame: 1-month post Stage II surgery
Change in Weight
Time frame: baseline, 3-months post Stage II surgery
Change in Heart Rate
Time frame: baseline, 3-months post Stage II surgery
Change in Oxygen Saturation
Time frame: baseline, 3-months post Stage II surgery
Change in Weight
Time frame: baseline, every 6 months post-Stage II surgery
Change in Arrhythmia and Heart Failure Medication
Time frame: 3-months post-surgery
Stage III Surgical Repair
Time frame: Stage III surgery pre-op, approx. 4 years
Total Time Until Listed for Cardiac Transplantation
Time frame: up to Stage III surgery pre-op, approx. 4 years
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC)
Time frame: baseline, Stage III surgery pre-op
Total Time Until Death
Time frame: approx 4 years
Cumulative Days of Hospitalization
Time frame: 3-months post Stage II surgery
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Jul 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40312733Gallego-Navarro C, Jaggers J, Burkhart HM, Carlo WF, Morales DL, Qureshi MY, Rossano JW, Hagen CE, Seisler DK, Peral SC, Nelson TJ. Autologous umbilical cord blood mononuclear cell therapy for hypoplastic left heart syndrome: a nonrandomized control trial of the efficacy and safety of intramyocardial injections. Stem Cell Res Ther. 2025 May 1;16(1):215. doi: 10.1186/s13287-025-04316-3.
- Mayo Clinic Clinical TrialsLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Frank Cetta, MD principal investigator
Mayo Clinic
Harold M. Burkhart, M.D. principal investigator
Children's Hospital Oklahoma University Medical Center
Joseph W. Rossano, M.D. principal investigator
Children's Hospital of Philadelphia
8 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Autologous (self) mononuclear cells derived from umbilical cord blood and Stage II Surgical repair in people with Hypoplastic Left Heart Syndrome, run by Timothy J Nelson, MD, PhD at 8 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 8 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 8 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Jul 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Right Ventricular Cardiac Function Measured by Apical Fractional Area Change (FAC) (time frame: baseline, 3 months post-Stage II surgery). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03779711, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jul 2025.