Autologous Cord Blood Cell Therapy for Neonatal Encephalopathy

This is a multicenter pilot study to evaluate the feasibility and safety of intravenous infusions of autologous (the patient's own) umbilical cord blood cells in term gestation newborns with neonatal encephalopathy (hypoxic-ischemic encephalopathy). If a neonate is born with signs of moderate to severe encephalopathy and cooled for the encephalopathy, the neonate can receive their own non-cryopreserved volume- and red blood cell-reduced cord blood cells. The cord blood cells are divided into 3 doses and infused at 12-24, 36-48, and 60-72 hours after the birth. Infants will be followed for safety and neurodevelopmental outcome up to 18 months.

Inclusion criteria

Infants are eligible if they meet all the following inclusion criteria except 4.

• ≥36 weeks gestation
• Either a 10-minute Apgar score ≤5, continued need for resuscitation for at least 10 minutes, or severe acidosis, defined as pH <7.0 or base deficit ≥16 mmol/L in a sample of umbilical cord blood or any blood during the first hour after birth
• Moderate to severe encephalopathy (Sarnat II to III)
• A moderately or severely abnormal background amplitude-integrated EEG (aEEG) voltage, or seizures identified by aEEG, if monitored
• Up to 24 hours of age
• Autologous umbilical cord blood available to infuse within 3 days after birth
• A person with parental authority must have consented for the study.

Exclusion criteria

• Known major congenital anomalies, such as chromosomal anomalies, heart diseases
• Major intracranial hemorrhage identified by brain ultrasonography or computed tomography
• Severe growth restriction, with birth-weight less than 1800 g
• Severe infectious disease, such as sepsis
• Hyperkalemia
• Outborn infants (Infants born at hospitals other than the study sites)
• Volume of collected cord blood <40 ml
• Infants judged critically ill and unlikely to benefit from neonatal intensive care by the attending neonatologist