Clinical applications of hepatocyte transplantation

Abstract

The shortage of organ donors is a problem worldwide, with approximately 15% of adult patients with lifethreatening liver diseases dying while on the waiting list. The use of cell transplantation for liver disease is an attempt to correct metabolic defects, or to support liver function as a bridge to liver transplantation and, as such, has raised a number of expectations. Most of the available studies briefly reported here focus on adult hepatocyte transplantation (HT), and the results are neither reproducible nor comparable, because the means of infusion, amount of injected cells and clinical variability differ among the studies. To better understand the specific role of HT in the management of end-stage liver disease, it is important that controlled studies, designed on the principles of evidence-based medicine, be done in order to guarantee the reproducibility of results.

Hepatocyte Transplantation

“…4 Hepatocytes can function in ectopic sites, such as the peritoneal cavity with some clinical effectiveness. 2 Clinical and biochemical improvements have been reported in several studies of humans with fulminant hepatic failure (FHF) treated with intraperitoneal HT. 12 Unfortunately, these sites do not efficiently support cell viability for long periods because the transplanted cells have no direct and instant access to oxygen and nutrients.…”

“…9 The liver and the spleen are the most reliable sites used for transplantation. 2 In cases of metabolic liver disease and acute liver failure in which the liver architecture is intact, the presence of physiological matrix and the availability of portal blood supply make the liver the optimal site for HT. 4 The spleen has proven to be the best site for hepatocyte engraftment.…”

“…11 However, a large proportion remains in the spleen, which can serve as a site for long-term survival and function of engrafted hepatocytes. 2 Intrasplenic HT has been performed in animal models of chronic liver failure. In rats, 2 × 107 hepatocytes (representing approximately 3% of the host liver mass) to 7.5 × 107 hepatocytes (approximately 12.5% of the host liver mass) were transplanted into the splenic parenchyma, and only a transient portal hypertension was observed.…”

“…1 The shortage of organ donors is a problem worldwide, with approximately 15% of adult patients with lifethreatening liver diseases dying while on the waiting list. 2 Presently, cell therapies represent one of the most promising alternative solutions to entire or partial liver transplantation. 3 The use of autologous cells overcomes the problems associated with donor scarcity and immunosuppression.…”

Evaluation of Porous TiNi-based Alloy as a Scaffold for Liver Tissue Engineering

“…In this regard, one of the directions of regenerative cellular therapy was the use of isolated liver cells in tissue-engineering intracorporeal structures [8][9][10]. Many works are devoted to the cultivation of various cells in 3D matrices -scaffold (currently there are made commercial products) [11].…”