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A pilot study of autologous CD34-depleted bone marrow mononuclear cell transplantation via the hepatic artery in five patients with liver failure

 Chung-Hwa Park  ;  Si Hyun Bae  ;  Hee Yeon Kim  ;  Ja Kyung Kim  ;  Eun Sun Jung  ;  Ho Jong Chun  ;  Myeong Jun Song  ;  Sung-Eun Lee  ;  Seok Goo Cho  ;  Jong Wook Lee  ;  Jong Young Choi  ;  Seung Kew Yoon  ;  Nam Ik Han  ;  Young Sok Lee 
 Cytotherapy, Vol.15(12) : 1571-1579, 2013 
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Adult ; Bone Marrow Transplantation/adverse effects ; Bone Marrow Transplantation/methods ; Female ; Hepatic Artery/cytology ; Hepatic Artery/surgery ; Humans ; Leukocytes, Mononuclear/cytology ; Leukocytes, Mononuclear/transplantation ; Liver Cirrhosis/pathology ; Liver Cirrhosis/therapy ; Liver Failure/pathology ; Liver Failure/surgery ; Liver Failure/therapy ; Male ; Mesenchymal Stromal Cells/cytology ; Middle Aged ; Pilot Projects ; Transplantation, Autologous ; Treatment Outcome
autologous transplantation ; liver cirrhosis ; liver failure ; mesenchymal stromal cell
BACKGROUND AIMS: Many rodent experiments and human studies on stem cell therapy have shown promising therapeutic approaches to liver diseases. We investigated the clinical outcomes of five patients with liver failure of various causes who received autologous CD34-depleted bone marrow-derived mononuclear cell (BM-MNC) transplantation, including mesenchymal stromal cells, through the hepatic artery. METHODS: CD34-depleted BM-MNCs were obtained from five patients waiting for liver transplantation by bone marrow aspiration and using the CliniMACS CD34 Reagent System (Miltenyi Biotech, Bergisch Gladbach, Germany), and autologous hepatic artery infusion was performed. The causes of hepatic decompensation were hepatitis B virus (HBV), hepatitis C virus (HCV), propylthiouracil-induced toxic hepatitis and Wilson disease. RESULTS: Serum albumin levels improved 1 week after transplantation from 2.8 g/dL, 2.4 g/dL, 2.7 g/dL and 1.9 g/dL to 3.3 g/dL, 3.1 g/dL, 2.8 g/dL and 2.6 g/dL. Transient liver elastography data showed some change from 65 kPa, 33 kPa, 34.8 kPa and undetectable to 46.4 kPa, 19.8 kPa, 29.1 kPa and 67.8 kPa at 4 weeks after transplantation in a patient with Wilson disease, a patient with HCV, and two patients with HBV. Ascites decreased in two patients. One of the patients with HBV underwent liver transplantation 4 months after the infusion, and the hepatic progenitor markers (cytokeratin [CD]-7, CD-8, CD-9, CD-18, CD-19, c-Kit and epithelial cell adhesion molecule [EpCAM]) were highly expressed in the explanted liver. CONCLUSIONS: Serum albumin levels, liver stiffness, liver volume, subjective healthiness and quality of life improved in the study patients. Although these findings were observed in a small population, the results may suggest a promising future for autologous CD34-depleted BM-MNC transplantation as a bridge to liver transplantation in patients with liver failure.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김자경(Kim, Ja Kyung) ORCID logo https://orcid.org/0000-0001-5025-6846
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