Clinical Trials Study
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World J Gastroenterol. Jul 14, 2014; 20(26): 8660-8666
Published online Jul 14, 2014. doi: 10.3748/wjg.v20.i26.8660
Outcomes of autologous bone marrow mononuclear cell transplantation in decompensated liver cirrhosis
Yang-Qiu Bai, Yu-Xiu Yang, Ya-Ge Yang, Song-Ze Ding, Fang-Li Jin, Ming-Bo Cao, Yan-Rui Zhang, Bing-Yong Zhang
Yang-Qiu Bai, Yu-Xiu Yang, Song-Ze Ding, Ming-Bo Cao, Yan-Rui Zhang, Bing-Yong Zhang, Department of Gastroenterology and Hepatology, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
Ya-Ge Yang, Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China
Fang-Li Jin, The Seventh People’s Hospital of Zhengzhou City, Zhengzhou 450006, Henan Province, China
Author contributions: Yang YX and Zhang BY designed the experiment; Bai YQ, Yang YG and Jin FL performed the experiments; Bai YQ and Yang YG wrote the manuscript; Cao MB and Zhang YR coordinated the study; Ding SZ revised the manuscript.
Supported by Grants for Key Bio-Medical Research Projects in Henan Province, China, No. 2011020122, No. 112102310251
Correspondence to: Bing-Yong Zhang, MD, PhD, Department of Gastroenterology and Hepatology, Zhengzhou University People’s Hospital, No. 7 Wei Wu Road, Zhengzhou 450003, Henan Province, China. zhbingyong@sina.com.cn
Telephone: +86-371-65897728 Fax: +86-371-65964376
Received: January 27, 2014
Revised: April 10, 2014
Accepted: May 12, 2014
Published online: July 14, 2014
Processing time: 167 Days and 18.8 Hours
Abstract

AIM: To determine the long-term efficacy of autologous bone marrow mononuclear cells (BM-MNCs) transplantation in terms of improving liver function and reducing complications in patients with decompensated cirrhosis.

METHODS: A total of 47 inpatients with decompensated liver cirrhosis were enrolled in this trial, including 32 patients undergoing a single BM-MNCs transplantation plus routine medical treatment, and 15 patients receiving medical treatment only as controls. Forty-three of 47 patients were infected with hepatitis B virus. Bone marrow of 80-100 mL was obtained from each patient and the BM-MNCs suspension was transfused into the liver via the hepatic artery. The efficacy of BM-MNCs transplantation was monitored during a 24-mo follow-up period.

RESULTS: Liver function parameters in the two groups were observed at 1 mo after BM-MNCs transfusion. Prealbumin level was 118.3 ± 25.3 mg/L vs 101.4 ± 28.7 mg/L (P = 0.047); albumin level was 33.5 ± 3.6 g/L vs 30.3 ± 2.2 g/L (P = 0.002); total bilirubin 36.9 ± 9.7 mmol/L vs 45.6 ± 19.9 mmol/L (P = 0.048); prothrombin time 14.4 ± 2.3 s vs 15.9 ± 2.8 s (P = 0.046); prothrombin activity 84.3% ± 14.3% vs 74.4% ± 17.8% (P = 0.046); fibrinogen 2.28 ± 0.53 g/L vs 1.89 ± 0.44 g/L (P = 0.017); and platelet count 74.5 ± 15.7 × 109/L vs 63.3 ± 15.7 × 109/L (P = 0.027) in the treatment group and control group, respectively. Differences were statistically significant. The efficacy of BM-MNCs transplantation lasted 3-12 mo as compared with the control group. Serious complications such as hepatic encephalopathy and spontaneous bacterial peritonitis were also significantly reduced in BM-MNCs transfused patients compared with the controls. However, these improvements disappeared 24 mo after transplantation.

CONCLUSION: BM-MNCs transplantation is safe and effective in patients with decompensated cirrhosis. It also decreases the incidence of serious complications.

Keywords: Autologous, Bone marrow mononuclear cells, Transplantation, Liver cirrhosis, Hepatitis B virus

Core tip: We aimed to study the efficacy of autologous bone marrow mononuclear cells (BM-MNCs) transplantation in terms of improving liver function and reducing complications in patients with decompensated cirrhosis. Liver function parameters were improved one month after BM-MNCs transfusion in cirrhosis patients, firstly in prealbumin level, followed by albumin level, total bilirubin, prothrombin time, prothrombin activity, fibrinogen and platelet count. The efficacy of BM-MNCs transplantation lasted 3-12 mo as compared with the control group. However, these improvements disappeared 24 mo after transplantation.