European Journal of Gastroenterology and Hepatology

Autor: Lyra, André Castro, Soares, Milena Botelho Pereira, Silva, Luiz Flavio Maia da, Braga, Eduardo Lorens, Oliveira, Sheilla A., Fortes, Marcos Fraga, Silva, Andre Goyanna Pinheiro, Brustolim, Daniele, Genser, Bernd, Santos, Ricardo Ribeiro dos, Lyra, Luiz Guilherme Costa
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Zdroj: Repositório Institucional da UFBA
Universidade Federal da Bahia (UFBA)
instacron:UFBA
DOI: 10.1097/MEG.0b013e32832eb69a
Popis: Texto completo: acesso restrito. p.33-42 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-09-11T13:49:45Z No. of bitstreams: 1 00042737-201001000-00005.pdf: 262144 bytes, checksum: cd90401cc93bb9cd48cc317c3f9d7f97 (MD5) Approved for entry into archive by Rodrigo Meirelles (rodrigomei@ufba.br) on 2013-10-31T17:42:53Z (GMT) No. of bitstreams: 1 00042737-201001000-00005.pdf: 262144 bytes, checksum: cd90401cc93bb9cd48cc317c3f9d7f97 (MD5) Made available in DSpace on 2013-10-31T17:42:53Z (GMT). No. of bitstreams: 1 00042737-201001000-00005.pdf: 262144 bytes, checksum: cd90401cc93bb9cd48cc317c3f9d7f97 (MD5) Previous issue date: 2010 Aim: This randomized controlled study evaluated the effect of autologous infusion of bone marrow cells (BMC) in patients with hepatic cirrhosis. Methods: Thirty patients on the liver transplant waiting list were randomly assigned to receive BMC therapy or no treatment. They were followed up for 1 year. The study was nonblinded. Autologous mononuclear-enriched BMC were infused into the hepatic artery; liver function scores/tests were chosen as endpoints to assess efficacy. Statistical analysis calculated mean relative changes (RC) from baseline and fitted a random-effects model. Results: Mean age, baseline model for end-stage liver disease, and Child–Pugh score were similar in both groups. Child–Pugh score improved in the first 90 days in the cell therapy group compared with controls (P = 0.017, BMC group RC = -8%, controls RC = +5%). The model for end-stage liver disease score remained stable in the treated patients (RC -2 to +6%), whereas it increased during follow-up in the control group (RC +6 to +18%). Albumin levels improved in the treatment arm, whereas they remained stable among controls in the first 90 days (P = 0.034; BMC group RC = +16%, control group RC = +2%). Bilirubin levels increased among controls, whereas they decreased in the therapy arm during the first 60 days; INR RC differences between groups reached up to 10%. The changes observed did not persist beyond 90 days. Conclusion: Transplantation of autologous BMC into the hepatic artery improved liver function in patients with advanced cirrhosis in the first 90 days. However, larger studies are necessary to define the role of BMC therapy in cirrhotic patients. Repeated autologous BMC infusions or combination therapy with granulocyte-colony-stimulating factor might improve or sustain the treatment response.
Databáze: OpenAIRE