Autologous bone marrow mesenchymal stem cell transplantation in liver failure patients caused by hepatitis B: Short-term and long-term outcomes

Abstract

Our study aimed to investigate the short-term efficacy and long-term prognosis of liver failure patients caused by hepatitis B after a single transplantation with autologous marrow mesenchymal stem cells (MMSCs). A total of 527 inpatients with liver failure caused by hepatitis B were recruited and received the same medical treatments, among whom 53 patients underwent a single transplantation with autologous MMSCs. A total of 105 patients matched for age, sex, and biochemical indexes, including alanine aminotransferase (ALT), albumin, total bilirubin (TBIL), prothrombin time (PT), and Model for End-Stage Liver Disease (MELD), comprised the control group. A total of 120 mL of bone marrow was obtained from each patient and then diluted and separated. Then, the MMSC suspension was slowly transfused into the liver through the proper hepatic artery. The success rate of transplantation was 100%, without serious side effects or complications. Levels of ALB, TBIL, and PT and MELD score of patients in the transplantation group were markedly improved from 2-3 weeks after transplantation, compared with those in the control group. At 192 weeks of follow-up, there were no dramatic differences in incidence of hepatocellular carcinoma (HCC) or mortality between the two groups. Additionally, there were no significant differences in the incidence of HCC or mortality between patients with and without cirrhosis in the transplantation group. Conclusion: Autologous MMSC transplantation is safe for liver failure patients caused by chronic hepatitis B. Short-term efficacy was favorable, but long-term outcomes were not markedly improved. In respect to several parameters, this method is preferable for patients with liver cirrhosis and may have potential for reducing their incidence of HCC and mortality. (HEPATOLOGY 2011;54:820-828) H epatitis B is a major global health problem and the most serious type of viral hepatitis. It is one of the primary causes of liver cirrhosis, liver failure and is one of the major risk factors of hepatocellular carcinoma (HCC), with approximately 350 million people infected worldwide.1 The disease is particularly serious in some developing countries, and new, effective therapies are essential, in addition to current medical, antiviral, and immunomodulation treatments and liver transplantation.

Strategies for Bioengineered Scaffolds that Support Adipose Stem Cells in Regenerative Therapies

“…However, even the most common treatments show a significant and unpredictable loss of transplanted tissue volume over time. Volume loss For reprint orders, please contact: reprints@futuremedicine.com 10.2217/rme-2016-0064…”

“…Bone marrow-derived mesenchymal stem cells (BMMSCs) are a type of adult stem cell commonly used in numerous therapies including liver failure as a result of hepatitis B [10]. BM-MSCs have been approved for use in humans since 1995, and are currently being used in 272 clinical trials according to clinicaltrials.gov.…”

Stem cell therapies and regenerative medicine in China

“…Figure1 summarizes the approved projects and funding from the NSFC for stem cell-based research and trials, and the related articles published in Science Citation Index journals from 2008 to 2012. These achievements involved preclinical studies of stem cells and tissue engineering products for coronary heart diseases, diabetes, liver failure, sweat gland injury after burns, and other serious diseases, which establish a solid foundation for clinical application and industrialization of future products [3][4][5][6][7][8]. However, the therapeutic market for stem cell applications is not mature enough in China, resulting in a lack of large-scale market-oriented stem cell-based products.…”

Stem cell treatment in gastroenterology and hepatology

“…A las 2-3 semanas tras el tratamiento mejoraron los niveles de albúmina, bilirrubina, actividad de protrombina y la puntuación MELD. Sin embargo, a las 192 semanas de seguimiento no se apreciaban diferencias significativas respecto a la mortalidad o incidencia de hepatocarcinoma entre los dos grupos, que se deberían de valorar en estudios posteriores con más sujetos (29). En otro estudio egipcio, se extrajeron células madre de médula ósea a 20 pacientes con hepatitis crónica C que posteriormente se diferenciaron a hepatocitos para ser infudidos en los mismos pacientes, demostrando la seguridad y la eficacia a corto plazo de este tratamiento respecto a los controles tratados de manera convencional, pues mejoraba la puntuación de Child-Pugh y el MELD (30).…”