Abstract
Toxic, viral and surgical injuries can pose medical indications for liver transplantation. The number of patients waiting for a liver transplant still increases, but the number of organ donors is insufficient. Hepatocyte transplantation was suggested as a promising alternative to liver transplantation, however, this method has some significant limitations. Currently, afterbirth tissues seem to be an interesting source of cells for the regenerative medicine, because of their unique biological and immunological properties. It has been proven in experimental animal models, that the native stem cells, and to a greater extent, hepatocyte-like cells derived from them and transplanted, can accelerate regenerative processes and restore organ functioning. The effective protocol for obtaining functional mature hepatocytes in vitro is still not defined, but some studies resulted in obtaining functionally active hepatocyte-like cells. In this review, we focused on human stem cells isolated from placenta and umbilical cord, as potent precursors of hepatocyte-like cells for regenerative medicine. We summarized the results of preclinical and clinical studies dealing with the introduction of epithelial and mesenchymal stem cells of the afterbirth origin to the liver failure therapy. It was concluded that the use of native afterbirth epithelial and mesenchymal cells in the treatment of liver failure could support liver function and regeneration. This effect would be enhanced by the use of hepatocyte-like cells obtained from placental and/or umbilical stem cells.Graphical abstract
Highlights
The number of patients waiting for a liver transplant increases every year
Positive effect of human amnion cells was observed in case of acquired failure caused by chemical damage and in congenital failure caused by inborn errors of metabolism [12]
They express the CD47 antigen responsible for "don't eat me signal", and complement antigen complex CD44/CD59 [13]. It seems that the positive effect is greater, when the used cells are close to the mature hepatocytes [14]
Summary
The number of patients waiting for a liver transplant increases every year. This is caused, among other reasons, by clinically justified transplant indications and insufficient number of organ donors. HPC differ phenotypically and functionally from human liver multipotent stem cells expressing mesenchymal markers [52, 59]. Positive effects of hAEC and their derivatives, such as improved liver function, reduction of fibrosis and inflammation, raise the question about the necessity of stem cells differentiation towards hepatocytes, if the use of native amniotic cells gives promising results.
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