The impact of repeated autologous infusion of haematopoietic stem cells in patients with liver insufficiency

Abstract

IntroductionThe worldwide shortage of donor livers has prompted the search for alternative cell therapies. Previous data from our laboratory proved a supportive role for stem cell therapy in the treatment of end-stage liver disease patients. Therefore; this study was conducted to assess the clinical and biochemical effects of repeated stem cell infusion.MethodsNinety patients with liver cirrhosis were randomized to receive either one session treatment (G-I) or two sessions 4 months apart (G-II) of autologous haematopoietic stem cells (HSCs) transplantation and a control group (G-III) who received regular liver treatment. G-CSF was administered to transplanted patients before infusion; HSCs were isolated from 400 cc bone marrow (BM) aspirate. CD34+/CD133+ cells were purified: 50 % of the cells were infused locally in the portal vein on the same day and the other 50 % were differentiated to MSC and infused systemically in a peripheral vein (one session treatment G-I). In G-II, the same process was repeated after 4 months from the first treatment (two session’s treatment G-II). Liver function was monitored for 12 months after stem cell therapy (SCT).ResultsStatistically significant improvement was reported in the transplanted patients (G-1) as regards the mean serum albumin, bilirubin and INR levels which started to improve after 2 weeks of treatment and continued to improve till the 6th month in the single infusion group. The two sessions infused group (G-II) showed sustained response which continued throughout the all follow-up period (12 month). By the end of the study, 36.7 % of the patients in G-I and 66.7 % in G-II showed improvement in the degree of ascites compared to the control group (G-III). We also reported an improvement in the hepatic functional reserve as assessed by the Child-Pugh and MELD score. Safety of the procedure was evidenced by the low incidence of complications encountered.ConclusionIn patients with end-stage liver disease, the repeated infusion with combined routes portal and peripheral veins has a beneficial effect on liver functions with minimal adverse events and more lasting clinical efficacy after repeated HSCs infusion.

Characteristics and potentials of stem cells derived from human degenerated nucleus pulposus: potential for regeneration of the intervertebral disc

“…Recent advances in the field of mesenchymal stromal cells (MSCs) offer promising applications in several other fields [10–12]. However, in IVDD, the harsh environment of high compressive load, acidic pH, hypoxia, hyperosmolarity, and limited nutrition makes it difficult for exogenous cells to survive and proliferate [13–15].…”

Collagen biomaterial stimulates the production of extracellular vesicles containing microRNA‐21 and enhances the proangiogenic function of CD34 + cells

“…For both circulating and resident BM hematopoietic stem/progenitor cells, CD34 positivity has been exploited to develop relatively simple methods for purification using immunomagnetic selection (12). Clinical safety and feasibility for these purified cells has been demonstrated for some medical problems, including refractory severe aplastic anemia (13), stroke (14), critical limb ischemia (15,16), nonischemic dilated cardiomyopathy (17), liver cirrhosis (18,19), and myocardial infarction (20,21). CD34 + cells are an attractive option for revascularization therapy because they are rapidly mobilized from the BM into the peripheral blood after injury (22)(23)(24) and then home to the site of tissue damage and contribute to vascular repair and angiogenesis (25)(26)(27).…”

Preoperative nutrition and postoperative liver function: a correlation study of pediatric living donor liver transplantation

“…A variety of primary diseases has led Chinese pediatric patients to suffer from liver cirrhosis, especially biliary atresia (BA), which has threatened their health and lifespan; fortunately, significant progress in the field of liver transplantation 1 has made this treatment the most effective therapeutic strategy for pediatric patients with end-stage liver diseases. 2 Several transplantation centers have begun to perform living donor liver transplantation (LDLT) since the first case of pediatric liver transplantation was successfully performed in the mainland of China in May 1996. 3 The outcomes of pediatric LDLT have been greatly improved and broadly recognized.…”