Department of Surgical and Gastroenterological Sciences, Gastroenterology Unit, University of Padova, Padova, Italy.
Best Pract Res Clin Gastroenterol. 2012 Feb;26(1):35-45. doi: 10.1016/j.bpg.2012.01.001.
Orthotopic liver transplantation (OLT) represents the only reliable therapeutic approach for acute liver failure (ALF), liver failure associated to end-stage chronic liver diseases (CLD) and non-metastatic liver cancer. The clinical impact of liver failure is relevant because of the still high ALF mortality and the increasing worldwide prevalence of cirrhosis that, in turn, is the main predisposing cause for hepatocellular carcinoma (HCC). Moreover, in the next decade because an increased number of patients reaching end-stage disease and requiring OLT may face a shortage of donor livers. This clinical scenario led several laboratories to explore the feasibility and efficiency of alternative approaches, involving cellular therapy, to counteract liver failure. The present chapter overviews results and concepts emerged from recent experimental and clinical studies in which adult or embryonic hepatocytes, hepatic stem/progenitor cells, induced pluripotent stem (iPS) cells as well as extrahepatic stem cells have been used as putative transplantable cell sources.
原位肝移植（OLT）是急性肝衰竭（ALF）、终末期慢性肝病（CLD）相关肝衰竭和非转移性肝癌的唯一可靠治疗方法。肝衰竭的临床影响是相关的，因为 ALF 的死亡率仍然很高，而且全球肝硬化的患病率也在不断增加，而肝硬化反过来又是肝细胞癌（HCC）的主要诱发原因。此外，在未来十年，由于越来越多的患者达到终末期疾病并需要 OLT，可能会面临供体肝脏短缺的问题。这种临床情况促使许多实验室探索替代方法的可行性和效率，包括细胞治疗，以对抗肝衰竭。本章综述了最近的实验和临床研究中出现的结果和概念，其中使用了成体或胚胎肝细胞、肝干细胞/祖细胞、诱导多能干细胞（iPS 细胞）以及肝外干细胞作为潜在的可移植细胞来源。
