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.