search
Back to results

Clinical Observation of CABA System in the Treatment of End-stage Liver Disease With Inflammation

Primary Purpose

To Evaluate the Clinical Efficacy and Safety of the New ALSS

Status
Recruiting
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
New artificial liver CABA system (BS330+CA280) +PE
Sponsored by
Qin Ning
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for To Evaluate the Clinical Efficacy and Safety of the New ALSS

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: ① Age 18-70; ② Patients with end-stage liver disease, including patients with acute decompensation of cirrhosis, chronic liver failure and patients with chronic and acute liver failure in Child-Pugh grade B-C; A. Acute decompensation of liver cirrhosis: ALB<35 g/L; A / G <1.0; TBIL> 120 μ mol / L; ALT> 1 × ULN and/or AST>1 × ULN; PTA <60% Ascites or hepatic encephalopathy or bleeding from esophageal varices; B. Chronic liver failure: The basis of chronic liver disease: decompensated cirrhosis; Time of onset: unlimited; Hepatic encephalopathy: with or without; Coagulation: PTA ≤ 40% or INR ≥ 1.5; Jaundice>171.1umol/L; C. Chronic plus acute liver failure: Chronic liver disease is based on: chronic hepatitis or decompensated cirrhosis; Time of onset:<4 weeks; Hepatic encephalopathy: with or without; Coagulation: PTA ≤ 40% or INR ≥ 1.5; Jaundice: TBIL ≥ 171 μ Mol/L or daily increase ≥ 17.1 μ mol/L ③ Inflammation status: the following 4 items meet any 2 items PCT≥0.50 μ g/L CRP≥40 mg/L IL-6 > 5 × ULN IL-8 > 5 × ULN ④ Understand and voluntarily sign the informed consent form approved by the Ethics Committee. Exclusion Criteria: Patients with liver malignant tumor and other tumors; People with HIV infection or other immunodeficiency diseases; Pregnant or lactating women; Patients with autoimmune disease, unstable stage of infarction caused by cardio-cerebrovascular accident, history of organ transplantation and other organ dysfunction or failure; ⑤ Patients with other serious complications (such as active bleeding, diffuse intravascular coagulation); ⑥ Those who are unable to return to the hospital for further consultation and follow-up regularly according to the research plan; Those who fail to comply with the research arrangement and sign the informed consent form; ⑧ Other conditions judged by the researcher not suitable for the group.

Sites / Locations

  • Tongji HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

CABA group

control group

Arm Description

new artificial liver CABA system (BS330+CA280) combined with plasma exchange

BS330 combined with plasma exchange

Outcomes

Primary Outcome Measures

non-transplantation mortality
the 28-day and 90-day non-transplantation mortality

Secondary Outcome Measures

Full Information

First Posted
March 8, 2023
Last Updated
March 21, 2023
Sponsor
Qin Ning
search

1. Study Identification

Unique Protocol Identification Number
NCT05780190
Brief Title
Clinical Observation of CABA System in the Treatment of End-stage Liver Disease With Inflammation
Official Title
Clinical Observation of New Artificial Liver CABA System (BS330+CA280) in the Treatment of End-stage Liver Disease With Inflammation
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 10, 2023 (Actual)
Primary Completion Date
March 8, 2024 (Anticipated)
Study Completion Date
March 8, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Qin Ning

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
End-stage liver disease (ESLD) refers to the late stage of liver disease caused by various chronic liver damage. ESLD is an important cause of global incidence rate and mortality, which has a significant impact on the health care system. ESLD is associated with various types of immune dysfunction. The artificial liver support system (ALSS) is an extracorporeal support system that temporarily and partially replaces the partial function of the liver. Its treatment mechanism is to remove all kinds of harmful substances, supplement essential substances, improve the internal environment, create conditions for hepatocyte regeneration and liver function recovery, or use it as a symptomatic support treatment method during the perioperative period of liver transplantation. In this study, we plan to use BS330 for plasma bilirubin adsorption. On this basis, we will add a CA280 cytokine adsorption column to establish a new artificial liver combination model CABA for the immune inflammatory damage mechanism of liver failure.
Detailed Description
End-stage liver disease (ESLD) refers to the late stage of liver disease caused by various chronic liver damage. Its main feature is that the liver function cannot meet the physiological needs of the human body. Its scope includes the end stage of various chronic liver diseases, including chronic plus acute liver failure (ACLF), acute decompensation of cirrhosis (ADC), chronic liver failure (CLF) and hepatocellular carcinoma. ESLD is an important cause of global incidence rate and mortality, which has a significant impact on the health care system. ESLD is associated with various types of immune dysfunction. The symptoms of these immune dysfunction are called cirrhosis-related immune dysfunction (CAID), characterized by immune deficiency and systemic inflammation caused by the continuous and inappropriate activation of immune cells. In compensated cirrhosis, even without intestinal bacterial translocation, the damage-related molecular patterns (DAMPs) released by necrotic hepatocytes can activate the immune system and cause systemic inflammation. During the decompensation period, the bacterial products produced by intestinal bacterial translocation enhance immune activation and increase the expression of pro-inflammatory cytokines and immune cell activation antigens in the circulation. Cytokines are the key components of the immune system, with a variety of characteristics and biological functions. Systemic inflammation associated with CAID is associated with increased circulating levels of pro-inflammatory cytokines such as interleukin (IL) - 6. Studies have shown that there is a relationship between the severity of immune disorders and the prognosis of liver cirrhosis. The levels of IL-6, IL-10 and IL-17 are increased in liver cirrhosis. The artificial liver support system (ALSS) is an extracorporeal support system that temporarily and partially replaces the partial function of the liver. Its treatment mechanism is to remove all kinds of harmful substances, supplement essential substances, improve the internal environment, create conditions for hepatocyte regeneration and liver function recovery, or use it as a symptomatic support treatment method during the perioperative period of liver transplantation. Plasma bilirubin adsorption is the specific adsorption of bilirubin through anion resin adsorption column, which can effectively reduce the level of bilirubin and bile acid, thus improving the internal environment of the machine and helping the further repair of damaged liver cells. Cytokine adsorption is designed to reduce the level of cytokines represented by IL-6 through the cytokine adsorption column. In clinical practice, it is mainly used to reduce the level of circulating pro-inflammatory cytokines and early harmful effects in the first few hours and days of treatment of infectious shock, so as to improve the treatment effect of patients. In this study, we plan to use BS330 for plasma bilirubin adsorption. On this basis, we will add a CA280 cytokine adsorption column to establish a new artificial liver combination model CABA for the immune inflammatory damage mechanism of liver failure. This treatment model can not only absorb bilirubin, but also effectively remove more inflammatory factors. In this study, patients with end-stage liver disease and inflammatory status will be selected as the observation object, and the new CABA combination will be used for treatment, and the clinical effectiveness and safety of this treatment mode will be evaluated, aiming to provide evidence-based medical evidence for the clinical application and promotion of this treatment mode.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
To Evaluate the Clinical Efficacy and Safety of the New ALSS

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
CABA+PE+standard drug therapy and PP+PE+standard drug therapy
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
CABA group
Arm Type
Experimental
Arm Description
new artificial liver CABA system (BS330+CA280) combined with plasma exchange
Arm Title
control group
Arm Type
Experimental
Arm Description
BS330 combined with plasma exchange
Intervention Type
Device
Intervention Name(s)
New artificial liver CABA system (BS330+CA280) +PE
Other Intervention Name(s)
standard drug therapy
Intervention Description
The new artificial liver CABA system (BS330+CA280) combioned plasma exchange in the treatment of end-stage liver disease with inflammatory status
Primary Outcome Measure Information:
Title
non-transplantation mortality
Description
the 28-day and 90-day non-transplantation mortality
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: ① Age 18-70; ② Patients with end-stage liver disease, including patients with acute decompensation of cirrhosis, chronic liver failure and patients with chronic and acute liver failure in Child-Pugh grade B-C; A. Acute decompensation of liver cirrhosis: ALB<35 g/L; A / G <1.0; TBIL> 120 μ mol / L; ALT> 1 × ULN and/or AST>1 × ULN; PTA <60% Ascites or hepatic encephalopathy or bleeding from esophageal varices; B. Chronic liver failure: The basis of chronic liver disease: decompensated cirrhosis; Time of onset: unlimited; Hepatic encephalopathy: with or without; Coagulation: PTA ≤ 40% or INR ≥ 1.5; Jaundice>171.1umol/L; C. Chronic plus acute liver failure: Chronic liver disease is based on: chronic hepatitis or decompensated cirrhosis; Time of onset:<4 weeks; Hepatic encephalopathy: with or without; Coagulation: PTA ≤ 40% or INR ≥ 1.5; Jaundice: TBIL ≥ 171 μ Mol/L or daily increase ≥ 17.1 μ mol/L ③ Inflammation status: the following 4 items meet any 2 items PCT≥0.50 μ g/L CRP≥40 mg/L IL-6 > 5 × ULN IL-8 > 5 × ULN ④ Understand and voluntarily sign the informed consent form approved by the Ethics Committee. Exclusion Criteria: Patients with liver malignant tumor and other tumors; People with HIV infection or other immunodeficiency diseases; Pregnant or lactating women; Patients with autoimmune disease, unstable stage of infarction caused by cardio-cerebrovascular accident, history of organ transplantation and other organ dysfunction or failure; ⑤ Patients with other serious complications (such as active bleeding, diffuse intravascular coagulation); ⑥ Those who are unable to return to the hospital for further consultation and follow-up regularly according to the research plan; Those who fail to comply with the research arrangement and sign the informed consent form; ⑧ Other conditions judged by the researcher not suitable for the group.
Facility Information:
Facility Name
Tongji Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430030
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yang Zhongyuan, MD/PhD
Phone
0086 2783662391
Email
1049446560@qq.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Clinical Observation of CABA System in the Treatment of End-stage Liver Disease With Inflammation

We'll reach out to this number within 24 hrs