Table 2.
Inclusion criteria | Exclusion criteria |
---|---|
– Age: 18–70 years (inclusive) – Clinical frailty index < 5 [60] – Evidence of TBI confirmed by abnormalities consistent with trauma on CT scan upon admission (Marshall’s CT Classification > 1) – Study drug (MSCs/placebo) administration start within 48 h from TBI – GCS ≤ 8 at recruitment and at least one pupil reactive to light – ICP monitoring, already inserted or planned for clinical indications – Weight < 100 kg and > 40 kg |
– Motor GCS > 5 at recruitment – High likelihood (> 85%) of death in the first 48 h calculated by IMPACT calculator [61] on early admission data – Bilateral unreactive mydriasis – Opening ICP > 40 mmHg – Known history of prior brain injury, psychiatric disorder, neurological impairment and/or deficit – Brain penetrating injury – Spinal cord injury – Epilepsy requiring ongoing anti-convulsant therapy – Severe organ failure (including PaO2/FiO2 < 200 and shock) – Recent serious infectious process requiring ICU admission – Cancer (ongoing) – Immunosuppression – Human immunodeficiency virus – Positive urine pregnancy test or breastfeeding – Known risk/history of coagulopathy and thromboembolism – Pre-existing and severe: ▪ Lung disease (such as asthma, chronic obstructive pulmonary disease) ▪ Heart dysfunction (as heart failure and reduced cardiac output) ▪ Liver insufficiency (as cirrhosis) ▪ Kidney insufficiency ▪ and other organ severe abnormalities – Known hypersensitivity to excipients used in the formulation (dimethyl sulfoxide, DMSO; citrate-dextrose solution, ACD) – Participation in a concurrent interventional study |
CT, computed tomography; GCS, Glasgow Coma Scale; ICP, intracranial pressure; ICU, intensive care unit; IMPACT, international mission for prognosis and clinical trial; MSCs, mesenchymal stromal cells; TBI, traumatic brain injury