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Intraportal therapy of autologous bone marrow mononuclear cells in patients on the waiting list for liver transplantation
- Authors: Granov DA1, Sheraliev AR1, Gerasimova OA1, Polikarpov AA1
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Affiliations:
- A.M. Granov Russian Research Center of Radiology and Surgical Technologies
- Issue: Vol 18, No 3 (2018)
- Pages: 32-40
- Section: Articles
- URL: https://journals.eco-vector.com/MAJ/article/view/10929
- DOI: https://doi.org/10.17816/MAJ18332-40
- ID: 10929
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Abstract
This study was carried out to explore the methodology of intraportal infusion of autologous bone marrow mononuclear cells in patients in the waiting list for liver transplantation. The study included eight patients. The Model for End-Stage Liver Disease (MELD) score as a predictor of hepatic failure exceeds 10 points, i.e., 12-22 points. According to Child-Turcotte-Pugh (CTP) classification, the severity of cirrhosis ranged from class B to C. The bone marrow volume of 224-320 ml was harvested by bilateral aspiration from the posterior iliac crest. The total volume of the mononuclear cells (MNC) was 47.1-58.3 ml (median, 47 ml). The absolute viable count of isolated MNC was 1.24 · 109-5.84 · 109 and CD34+ cells 2.54 · 106-48.20 · 106. After portal vein catheterization, direct transhepatic portography was performed, and portosystemic collaterals were found in all cases. Portal flowmetry was performed to determine the optimal selective perfusion rate of the segmental branches of the portal vein. Portal vein infusion was performed at 0.3-1.5 ml/sec. Serious side effects were not detected during bone marrow harvesting and MNC infusion. All patients had stable condition (no deterioration was initially noticed) after MNC infusion according to the MELD score and CTP criteria during a 3-month observation. Moreover, improvement in physical health status was observed and obtained using the SF-36 questionnaire. This study confirmed the safety of using intraportal therapy of autologous bone marrow MNC in patients on the waiting list for liver transplantation. Herein, we presented the technique of target delivery of autologous bone marrow MNC to the liver to minimize their loss during intraportal infusion. Prolonged follow-up time and improvement of the present technique are needed for further evaluation of the efficiency of autologous bone marrow MNC.
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About the authors
D A Granov
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
A R Sheraliev
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
O A Gerasimova
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
A A Polikarpov
A.M. Granov Russian Research Center of Radiology and Surgical Technologies
References
- Шевела Е.Я., Старостина Н.М., Пальцев А.И., и др. Эффективность клеточной терапии при циррозе печени // Клеточные технологии в биологии и медицине. - 2015. - № 4. - С. 232-138. [Shevela EY, Starostina NM, Pal’tsev AI, et al. Effektivnost’ kletochnoy terapii pri tsirroze pecheni. Kletochnye tekhnologii v biologii i meditsine. 2015;(4):232-138. (In Russ.)]
- Готье С.В., Хомяков С.М. Донорство и трансплантация органов в Российской Федерации в 2016 году // Вестник трансплантологии и искусственных органов. - 2017. - Т. 19. - № 2. - С. 6-26. [Gautier SV, Khomyakov SM. Donorstvo i transplantatsiya organov v Rossiyskoy Federatsii v 2016 godu. Vestnik transplantologii i iskusstvennykh organov. 2017;19(2):6-26. (In Russ.)]
- Andreone P, Catani L, Margini C, et al. Reinfusion of highly purified CD133+ bone marrow-derived stem/progenitor cells in patients with end-stage liver disease: A phase I clinical trial. Dig Liver Dis. 2015;47(12):1059-1066. doi: 10.1016/j.dld.2015.08.018.
- Vassilopoulos G, Wang PR, Russell DW. Transplanted bone marrow regenerates liver by cell fusion. Nature. 2003;422(6934):901-904. doi: 10.1038/nature01539.
- Fiegel HC, Lioznov MV, Cortes-Dericks L, et al. Liver-specific gene expression in cultured human hematopoietic stem cells. Stem Cells. 2003;21(1):98-104. doi: 10.1634/stemcells.21-1-98.
- am Esch JS, 2nd, Knoefel WT, Klein M, et al. Portal application of autologous CD133+ bone marrow cells to the liver: a novel concept to support hepatic regeneration. Stem Cells. 2005;23(4):463-470. doi: 10.1634/stemcells.2004-0283.
- Lee KD, Kuo TK, Whang-Peng J, et al. In vitro hepatic differentiation of human mesenchymal stem cells. Hepatology. 2004;40(6):1275-1284. doi: 10.1002/hep.20469.
- Peng L, Xie DY, Lin BL, et al. Autologous bone marrow mesenchymal stem cell transplantation in liver failure patients caused by hepatitis B: short-term and long-term outcomes. Hepatology. 2011;54(3):820-828. doi: 10.1002/hep.24434.
- Alison MR, Poulsom R, Jeffery R, et al. Hepatocytes from non-hepatic adult stem cells. Nature. 2000;406(6793):257. doi: 10.1038/35018642.
- Levicar N, Pai M, Habib NA, et al. Long-term clinical results of autologous infusion of mobilized adult bone marrow derived CD34+ cells in patients with chronic liver disease. Cell Prolif. 2008;41 Suppl 1:115-125. doi: 10.1111/j.1365-2184.2008.00491.x.
- Rehman J, Traktuev D, Li J, et al. Secretion of angiogenic and antiapoptotic factors by human adipose stromal cells. Circulation. 2004;109(10):1292-1298. doi: 10.1161/01.CIR.0000121425.42966.F1.
- Terai S, Ishikawa T, Omori K, et al. Improved liver function in patients with liver cirrhosis after autologous bone marrow cell infusion therapy. Stem Cells. 2006;24(10):2292-2298. doi: 10.1634/stemcells.2005-0542.
- Sato Y, Araki H, Kato J, et al. Human mesenchymal stem cells xenografted directly to rat liver are differentiated into human hepatocytes without fusion. Blood. 2005;106(2):756-763. doi: 10.1182/blood-2005-02-0572.
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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).