Initial outcomes of autologous bone-marrow stem cell transplantation in patients with alcoholic decompensated cirrhosis

  • Nguyen Tien Thinh 108 Military Central Hospital

Main Article Content

Keywords

Stem cells, bone marrow, alcoholic cirrhosis

Abstract

Objective: To evaluate the efficacy of autologous bone marrow stem cell transplantation on liver function, histopathology, and hepatic vein pressure gradient. Subject and method: Prospective method, comparing before and after treatment alcoholic decompensated cirrhosis with autologous bone marrow stem cells. Results were evaluated according to the Child-Pugh score, MELD score, histopathological images, and hepatic vein pressure gradient. The patients were followed up at 1, 3, and 6 months after transplantation. Result: The study included 10 alcoholic decompensated cirrhosis patients with bone marrow stem cell transplantation. The CD34+ cell of bone marrow fluid collected was 0.853 x 106 cells/ml. There was a significant improvement in the clinical profile containing jaundice and ascites. No complication was observed in those patients during follow-up. Albumin level was significantly increased after transplantation in comparison with before treatment with p<0.05. After 6 months, Child-Pugh score was significantly higher than before treatment (T0) with values 5.50 ± 1.58 and 6.90 ± 2.08, respectively. There was no improvement in the MELD score, histopathological images, and hepatic vein pressure gradient. Conclusion: Liver function significantly improved in alcoholic decompensated cirrhosis patients after treatment with autologous bone marrow stem cells, and no complication was observed relating to stem cell transplantation. 

Article Details

References

1. Huang DQ, Terrault NA, Tacke F et al (2023) Global epidemiology of cirrhosis aetiology, trends and predictions. Nat Rev Gastroenterol Hepatol: 388-398.
2. Takami T, Terai S, Sakaida I (2012) Advanced therapies using autologous bone marrow cells for chronic liver disease. Discovery Medicine 14: 7-12.
3. Crabb DW, Im GY, Szabo G, Mellinger JL, Lucey MR (2020) Diagnosis and treatment of alcohol-associated liver diseases: 2019 practice guidance from the American Association for the Study of Liver Diseases. Hepatology 71(1):306-333. doi: 10.1002/hep.30866.
4. Huang DQ, Mathurin P, Cortez-Pinto H et al (2023) Global epidemiology of alcohol-associated cirrhosis and HCC: trends, projections and risk factors. Nat Rev Gastroenterol Hepatol 20: 37-49.
5. Gordon FD (2012) Ascites. Clin Liver Dis 16: 285-299.
6. Lee H, Kim BK (2022) Real-world clinical features, health-care utilization, and economic burden in decompensated cirrhosis patients: A national database. J Gastroenterol Hepatol.
7. Ánh TN (2010) Vai trò của tiểu cầu, tỷ lệ AST, ALT, APRI trong đánh giá tình trạng xơ hóa gan. Tạp chí nghiên cứu y học, Trường Đại học Y Hà Nội, Tập 64: 4.
8. Zacharakis GH, Koskinas J, Kotsiou S, Papoutselis M, Tzara F, Vafeiadis N et al (2005) Natural history of chronic HBV infection: A cohort study with up to 12 years follow-up in North Greece (part of the Interreg I-II/EC-project). Journal of medical virology 77(2): 173-179.
9. Cẩm Phương P, Thị Thúy Quỳnh V, Văn Thái P & cộng sự (2022) Mô tả một số đặc điểm lâm sàng và cận lâm sàng ở bệnh nhân xơ gan. Tạp Chí Y học Việt Nam 508 (2022).
10. Nguyễn Tiến Thịnh, Đào Trường Giang, Bùi Tiến Sỹ và cộng sự (2019) Kết quả nghiên cứu sử dụng tế bào gốc tự thân trong điều trị xơ gan mất bù do HBV. Tạp chí Y Dược lâm sàng 108 (2019).
11. Khai LT, Ngoc NH, Tuyen NV, & Truong HX Evaluation of the effectiveness of the procedures of creating autologous stem cell product derived bone marrow fluid for treatment of ischemic stroke patients. Journal of 108 - Clinical Medicine and Phamarcy 15. https://doi.org/10.52389/ydls.v15iTA.740.
12. Hernández P, Cortina L, Artaza H et al (2007) Autologous bone-marrow mononuclear cell implantation in patients with severe lower limb ischaemia: A comparison of using blood cell separator and Ficoll density gradient centrifugation. Atherosclerosis 194(2): 52-56.
13. Mahmoud S, Abdo E, Helal S, Eldien H, Abdeltawab D, Abd-Elkader A (2019) Clinical and laboratory outcomes of stem cell transplantation in patients with decompensated liver cirrhosis: single-arm pilot trial. Journal of Current Medical Research and Practice 4(1): 44-9.
14. Deng Q, Cai T, Zhang S, Hu A, Zhang X, Wang Y et al (2015) Autologous peripheral blood stem cell transplantation improves portal hemodynamics in patients with Hepatitis B virus-related decompensated cirrhosis. Hepatitis monthly 15(12): 32498.
15. Saito T, Okumoto K, Haga H, Nishise Y, Ishii R, Sato C et al (2011) Potential therapeutic application of intravenous autologous bone marrow infusion in patients with alcoholic liver cirrhosis. Stem cells and development 20(9): 1503-1510.
16. Chen B, Pang L, Cao H, Wu D, Wang Y, Tao Y et al Autologous stem cell transplantation for patients with viral hepatitis-induced liver cirrhosis: a systematic review and meta-analysis. European journal of gastroenterology & hepatology 31(10): 1283-1391.
17. Knodell RG, Ishak KG, Black WC et al (1981) Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1(5): 431-435.
18. Jang YO, Kim YJ, Baik SK et al (2014) Histological improvement following administration of autologous bone marrow-derived mesenchymal stem cells for alcoholic cirrhosis: A pilot study. Liver international: Official journal of the International Association for the Study of the Liver 34(1): 33-41.