Chinese Medical Sciences Journal ›› 2014, Vol. 29 ›› Issue (1): 15-22.doi: 10.1016/S1001-9294(14)60018-3

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Clinical Outcome of Autologous Hematopoietic Stem Cell Infusion via Hepatic Artery or Portal Vein in Patients with End-stage Liver Diseases

Xiao-lun Huang1†, Le Luo1†, Lan-yun Luo1, Hua Xue1, Ling-ling Wei1, Yu-tong Yao1, Hai-bo Zou1, Xiao-bing Huang2, Yi-fan Zhu1, Tian Zhang3, Ping Xie3, Mao-zhu Yang1, Shao-ping Deng1, *   

  1. 1Center for Cell Transplantation (Seventh Unit of General Surgery Department), Institute of Organ Transplantation,;2Department of Blood Medicine,;3Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu 610072, China
  • Received:2013-11-12 Online:2014-03-31 Published:2014-03-31
  • Contact: Tel:86-28-87393752, E-mail:garrymd@163.com
  • Supported by:

    △Supported by the Science & Technology Department of Sichuan Province (2010FZ0098, 2011HH0022 ), Chengdu Bureau of Science and Technology (10GGYB883SF), the Scientific Research Foundation of the Health Department of Sichuan Province (100487, 100489).

Abstract:

Objective To investigate the efficacy of hematopoietic stem cell (HSC) transplantation via the hepatic artery vs. the portal vein for end-stage liver disease (ESLD).Methods Patients with hepatic decompensation were prospectively recruited from September 2010 to September 2012 to receive HSC transplantation via the hepatic artery or the portal vein. Liver function was examined at 3, 6, and 12 months after transplantation. Liver biopsy Results were analyzed using the Knodell score.Results Eighty patients (58 males and 22 females) were enrolled in the study. The Child-Pugh score was grade B in 69 cases, and grade C in the remaining 11 cases. HSC transplantation was performed via the portal vein in 36 patients and via the hepatic artery in 44 patients. ALT levels decreased while serum albumin levels increased significantly in both groups at 6 and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Total bilirubin levels decreased significantly in both groups at 3, 6, and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Additionally, prothrombin time decreased in both groups at 12 months after HSC transplantation (P<0.05 compared with pre-transplantation level). There were no significant differences in ALT, total bilirubin and prothrombin time between the two groups either before or after transplantation. Moreover, Knodell score decreased significantly at 6 and 12 months. Histological examination showed that liver cell edema, degeneration, necrosis, and inflammation were significantly relieved at 3, 6, and 12 months after transplantation. The incidence of portal vein thrombosis, upper gastrointestinal bleeding, and hepatic encephalopathy were 1.25%, 3.75%, and 2.5% respectively. The one-year survival rate was 100%.Conclusions Autologous HSC transplantation improves liver function and histology in ESLD patients. The administration route of HSC has no significant impact on the efficacy of transplantation.

Key words: end-stage liver diseases, autologous transplantation, hematopoietic stem cells, liver function

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