Efficacy of autologous mesenchymal stem cell transplantation in patients with liver cirrhosis
Murat Kantarcıoğlu, Hakan Demirci, Ferit Avcu, Yıldırım Karslıoğlu, Mustafa Alpaslan Babayiğit, Bülent Karaman, Kadir Öztürk, Hasan Gürel, Meral Akdoğan Kayhan, Sabite Kaçar, Ayhan Kubar, Gürol Öksüzoğlu, Ali Uğur Ural, Sait Bağcı, Murat Kantarcıoğlu, Hakan Demirci, Ferit Avcu, Yıldırım Karslıoğlu, Mustafa Alpaslan Babayiğit, Bülent Karaman, Kadir Öztürk, Hasan Gürel, Meral Akdoğan Kayhan, Sabite Kaçar, Ayhan Kubar, Gürol Öksüzoğlu, Ali Uğur Ural, Sait Bağcı
Abstract
Background/aims: Because of several limitations and complications of liver transplantation, new alternative treatment modalities are required for patients with liver cirrhosis. Many study results encourage the use of autologous bone marrow-derived mesenchymal stem cells for liver diseases. In this study, we assessed the impact of autologous mesenchymal stem cell transplantation on liver tissue and liver chemistry.
Materials and methods: Twenty-five patients with biopsy-proven liver cirrhosis were enrolled in the study. Patients received 1×106 autologous mesenchymal stem cells/kg via a peripheral vein. Biochemical parameters were checked monthly. Periodical radiological screening and liver biopsies before mesenchymal stem cell transplantation were performed after 6 months. Liver specimens were assessed by a pathologist.
Results: No side effect was observed and the mesenchymal stem cell transplantation procedure was well tolerated. Twelve patients completed the study. In 8 patients, improvements in Model for End-Stage Liver Disease (MELD) scores were observed. Serum albumin levels markedly increased in the third month. In patients with non-responder hepatitis C, HCV RNA levels both became negative after mesenchymal stem cell transplantation. Histopathological examinations of liver tissues before and at 6 months after transplantation revealed no change in liver tissue regeneration or fibrosis. However, in 5 patients, hepatitis activity index scores decreased.
Conclusion: Autologous mesenchymal stem cell transplantation via peripheral vein is safe and feasible. Consecutive liver biopsy examinations suggested that mesenchymal stem cells could not reach the liver in a sufficient amount. Improvement in patients and clearance of HCV RNA may have occurred through immunomodulatory mediators secreted by transplanted mesenchymal stem cells, namely the "endocrine" effect.
Source: PubMed