Yao peng, Hu Daron, Wang shuai, Wen wei, Gong lijuan g ,et al. Institute of Liver Diseases, General Hospital of Beijing Military Region, Beijing, 100700 Key Words: Liver bone marrow stem cells transplantation human Introduction Recent advances have implicated that bone marrow-derived stem cells could differentiation into hepatocytes and play a important role in the regulation of liver regeneration. In this study, we use autologous BMSC act as the source cells, transplanted into the liver of patients with liver disease, and the BM-derived stem cells will transdifference and grow into the functional hepatocytes in liver. It will be a new therapies for acute and chronic liver disease, and seems to be an attractive prospect for liver repair after acute or chronic hepatic injury. Patients and Methods 1.1 Patients All patients from our hospital residents, aging 20-65 years. 150 patients were treatment group, 80 patients were control group . The written informed consent was assigned by the patients. 1.2 Transplantation of stem cells Bone marrow was harvested(50-100ml) from patients in the transplant group. To get the bone marrow stem cells(BMSC), bone marrow was processed by density gradient sedimentation use Ficoll-Paque PLUS. Under the supervision of X-ray, isolated stem cells were infused into liver via hepatic artery. 1.3 Follow up visits and evaluation At different time (1week, 4weeks,8weeks, 12weeks, 24weeks) after transplantation, ALT, TBIL, ALB, PTA were detected, and the survival rate and improve of symptom were investigated. Results 2.1 variation of liver Function of patients after Therapy with transplantation of autologous BMSC We observed the liver function of patients treatment with transplantation of autologous BMSC after different times £¨1week£¬2 week£¬4 week£¬8 week£¬12 week£¬24 week£©£¬ the results shown£¬ALT level gradually decrease within 8 weeks of treatment with transplantation of autologous BMSC£¬from 135.6 IU/L to 98.5 IU/L, Comparisons with before treatment £¬statistical significance was assumed at a value of P<0.05. however£¬ a little pick up appeared after 12weeks of treatment. After 8 weeks of transplantation with autologous BMSC£¬the TBIL level was decrease too£¬Comparisons with before treatment £¬Statistical significance was assumed at a value of P<0.05. The ALB level were enhanced after 24w of treatment£¬from 27.69g/L to 32.56 g/L£¬Comparisons with before treatment £¬P<0.01 . 2.2 variation of PTA of patients after therapy with transplantation of autologous BMSC We also observed the variation of PTA of patients after different times of treatment with transplantation of autologous BMSC£¬ the results shown£¬the PTA level gradually raised within 24 weeks of treatment with transplantation of autologous BMSC£¬Comparisons with before treatment £¬Statistical significance was assumed at a value of P<0.01. No improvement of PTA were found in control group 2.3 The proportion of complications in patients treated with/no transplantation of autologous BMSC To comprehend the affection of treatment with transplantation of autologous BMSC to the occurrence of complications, we also observed the proportion of complications(gastrointestional bleeding, hepatic encephalopathy, Intra- Abdominal infections and liver Cancer ) in patients during 24 weeks of treatment with transplantation of autologous BMSC£¬ the results shown, the proportion of complications were similar between the treatment group and control group, no statistical significance was found. 2.4 Outcome of patients after transplantation of autologous BMSC To understand the outcome of patients treated with transplantation of autologous BMSc, we observed the situation of live and liver transplantation of patients, within 24 weeks of treated with transplantation with autologous BMSC, 25 deaths£¨16.6%£© and 9 patients £¨6.0%£©received liver transplantation in experimental group, total 34patients£¨22.6%£©. 14 deaths£¨17.5%£© and 3 patients £¨3.8%£©received liver transplantation in control group, total 17 patients£¨21.3%£©.No significant between two groups, this seems to indicate that therapy with transplantation of autologous BMSC cann¡¯t improve the outcome of patients with serious liver disease. Conclusion Taken together, results of our preliminary clinical experiment shown, the treatment of transplantation with autologous BMSC could improve the liver function of patients with liver disease, but cann¡¯t improve the outcome of patients with serious liver disease. Because of the limit of time and cases number of our study, exact assessment to this method need further studies. |