Study on the interventional transplantation of autologous bone marrow mesenchymal stem cells in the treatment of patients with decompensate cirrhosis / 中国综合临床

ABSTRACT

Objective To evaluate the effect of autologous bone marrow-derived stem cell (MSCs)transplantation in the treatment of decompensated hepatic cirrhosis.Methods Bone marrow was harvested (150-200 ml) from 25 patients with decompensated cirrhosis and hepatic failure.The MSCs were isolated according to the method reported by Wollert and infused into liver via hepatic artery catheter.At different time points after the transplantation,the patients' liver function and prothrombin time(PT) were evaluated,and the survival rate and symptoms of the patients were recorded.Results All the serum biochemical indexes remained stable 2 weeks after the transplantation,and at 4 weeks after transplantation,levels of albumin was increased significantly in comparison with the preoperative level((30.91 ±4.00) g/L vs (26.65 ±5.30) g/L,t =3.07,P ＜0.05).At 12 weeks,the levels of albumin further increased((32.00 ±6.18) g/L vs (26.65 ±5.30) g/L,t =3.02 P ＜ 0.01).While at 12 weeks after operation,there was significant difference on the total bilirubin ((39.94 ± 21.15) mmol/L vs (125.01 ± 150.05) mmol/L; t =2.63,P ＜ 0.05),tolal bile acid ((41.63 ±33.91) μmol/L vs (78.00 ± 59.80) pmol/L;t =2.53,P ＜ 0.05) when compared with the preoperative level.4weeks after operation,the liver enzyme indicators changed significantly when compared with the preoperative level (P ＜0.05).At 12 weeks after operation,there was significant difference on the PT((14.71 ± 1.59) s vs (21.40 ± 6.07) s,t =5.01,P ＜ 0.01) and the level of fibrinogen ((2.64 ± 0.61) g/L vs (1.66 ± 0.94) g/L,t =4.17,P ＜0.01).1 week after the transplantation,90.67％ patients exhibited improved appetite and 88.5％patients showed better physical strength; at 2 weeks,hepatic face improved in 16 cases (63.5％),and spider telangiectasia was significantly reduced in 1 case;at 12 weeks,the survival rate of the patients was 77.44％,and 3 died or gave up treatment due to chronic liver failure complicated by spontaneous bacterial peritonitis,hepatorenal syndrome,or DIC.No complications associated with the transplantation occurred in these patients.Conclusion MSCs transplantation can significantly improve the liver function of patients with decompensated hepatic cirrhosis with good safety and effectiveness,but the indications should be strictly controlled.