Repeated Autologous Bone Marrow Transfusion through Portal Vein for Treating Decompensated Liver Cirrhosis after Splenectomy.

Weiwei Zhang,Mujian Teng,Lei Li,Yanhui Si,Qiling Liu,Xin Liu,Baochi Liu

doi:10.1155/2018/4136082

Abstract

Objective This study is aimed at examining the impact of repeated intraportal autologous bone marrow transfusion (ABMT) in patients with decompensated liver cirrhosis after splenectomy. Methods A total of 25 patients with decompensated liver cirrhosis undergoing splenectomy were divided into ABMT and control groups. The portal vein was cannulated intraoperatively using Celsite Implantofix through the right gastroomental vein. Both groups were given a routine medical treatment. Then, 18 mL of autologous bone marrow was transfused through the port in the patients of the ABMT group 1 week, 1 month, and 3 months after laminectomy, while nothing was given to the control group. All patients were monitored for adverse events. Liver function tests, including serum albumin (ALB), alanine aminotransferase (ALT), total bilirubin (TB), prothrombin activity (PTA), cholinesterase (CHE), α-fetoprotein (AFP), and liver stiffness measurement (LSM), were conducted before surgery and 1, 3, and 6 months after surgery. Results Significant improvements in ALB, ALT, and CHE levels and decreased LSM were observed in the ABMT group compared with those in the control group (P < 0.05). TB and PTA improved in both groups but with no significant differences between the groups. No significant changes were observed in AFP in the control group, but it decreased in the ABMT group. No major adverse effects were noted during the follow-up period in the patients of either group. Conclusions Repeated intraportal ABMT was clinically safe, and liver function of patients significantly improved. Therefore, this therapy has the potential to treat patients with decompensated liver cirrhosis after splenectomy. This trial was registered with the identification number of ChiCTR-ONC-17012592.

Highlights

Liver cirrhosis is an advanced-stage liver disease representing irreversible damage or scarring to the liver and is a major cause of mortality worldwide [1]
Positive results from stem cell therapy using animal models have led to the evaluation of the feasibility and safety of bone marrow cell (BMC) therapy in patients with chronic liver disease [4,5,6,7,8]
No significant differences were found between the two groups with regard to age, sex, and levels of ALT, ALB, CHE, total bilirubin (TB), prothrombin activity (PTA), routine blood test (white blood cell (WBC), red blood cell, and platelet (PLT)), liver stiffness measurement (LSM), Child–Pugh, and AFP

Summary

Introduction

Liver cirrhosis is an advanced-stage liver disease representing irreversible damage or scarring to the liver and is a major cause of mortality worldwide [1]. Recent advances in stem cell research have prompted the development of stem cell-based therapy in these patients since the stem cells, including bone marrow-derived stem cells, have the capacity for self-renewal and multilineage differentiation [3]. As an accessible source of stem cells, adult human bone marrow contains two major types of stem cells: hematopoietic stem cells (HSCs) and mesenchymal stromal cells (MSCs). HSCs are capable of both self-renewal and differentiation into multiple hematopoietic lineages, while MSCs are nonhematopoietic and represent a minute fraction (0.001%–0.01%) of the total nucleated cell population in the marrow [9]

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