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

Autor: Zekri AR; Molecular Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Kasr Al-Aini st., Fom El-Khaleeg, Cairo, 11976, Egypt. ncizekri@yahoo.com., Salama H; Hepatology and Tropical Medicine Department, El-Kasr Al-Aini School of Medicine, Cairo University, Cairo, 11441, Egypt. hsalama888@yahoo.com., Medhat E; Hepatology and Tropical Medicine Department, El-Kasr Al-Aini School of Medicine, Cairo University, Cairo, 11441, Egypt. dremanmedhat@hotmail.com., Musa S; Hepatology and Tropical Medicine Department, El-Kasr Al-Aini School of Medicine, Cairo University, Cairo, 11441, Egypt. sheriefmusa@yahoo.com., Abdel-Haleem H; Hepatology and Tropical Medicine Department, El-Kasr Al-Aini School of Medicine, Cairo University, Cairo, 11441, Egypt. arady_60@hotmail.com., Ahmed OS; Molecular Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Kasr Al-Aini st., Fom El-Khaleeg, Cairo, 11976, Egypt. ola_sayed@yahoo.com., Khedr HA; Hepatology and Tropical Medicine Department, El-Kasr Al-Aini School of Medicine, Cairo University, Cairo, 11441, Egypt. hananahh@hotmail.com., Lotfy MM; Molecular Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Kasr Al-Aini st., Fom El-Khaleeg, Cairo, 11976, Egypt. mai_special_micro@yahoo.com., Zachariah KS; Hepatology and Tropical Medicine Department, El-Kasr Al-Aini School of Medicine, Cairo University, Cairo, 11441, Egypt. gastroserag@gmail.com., Bahnassy AA; Pathology Department, National Cancer Institute, Cairo University, Cairo, 11976, Egypt. chaya2000@hotmail.com.
Jazyk: angličtina
Zdroj: Stem cell research & therapy [Stem Cell Res Ther] 2015 Jun 11; Vol. 6, pp. 118. Date of Electronic Publication: 2015 Jun 11.
DOI: 10.1186/s13287-015-0106-1
Abstrakt: Introduction: The 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.
Methods: Ninety 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).
Results: Statistically 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 6(th) 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.
Conclusion: In 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.
Databáze: MEDLINE
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