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在等待肝移植的肝衰竭患者中进行人肝细胞移植。

Human hepatocyte transplantation in patients with hepatic failure awaiting a graft.

作者信息

Pareja E, Gomez-Lechon M J, Cortes M, Bonora-Centelles A, Castell J V, Mir J

机构信息

Unidad de Cirugía y Trasplante Hepático y Pancreático, Hospital Universitari i Politècnic La Fe de Valencia, Universidad de Valencia, Valencia, Spain.

出版信息

Eur Surg Res. 2013;50(3-4):273-81. doi: 10.1159/000351332. Epub 2013 Jun 18.

Abstract

BACKGROUND

Hepatocyte transplantation (HT) has the potential to become a promising treatment to temporarily support liver function in patients with liver failure.

METHODS

Two patients, who had already received a liver transplant (LT) in the past, with an end-stage liver disease due to recurrent hepatitis C virus cirrhosis, suffering acute-on-chronic liver failure while on the waiting list for an LT, received HT as a bridge to whole-organ retransplantation. After HT and during intensive care unit admission, blood tests and ammonia levels were determined every 12 and 24 h, respectively, before and after each hepatocyte infusion.

RESULTS

The present study describes monitoring of analytical and clinical parameters and improvement of liver function following HT. In both patients, we managed to lower the blood ammonia levels and clinically improve the degree of hepatic encephalopathy, thus serving as a bridge to liver retransplantation in 1 patient.

CONCLUSIONS

We believe that this therapy may be an alternative treatment in patients with chronic liver disease who suffer episodes of acute decompensation as a bridge to conventional LT.

摘要

背景

肝细胞移植(HT)有可能成为一种有前景的治疗方法,用于临时支持肝功能衰竭患者的肝功能。

方法

两名既往已接受肝移植(LT)的患者,因复发性丙型肝炎病毒肝硬化导致终末期肝病,在等待肝移植期间发生慢加急性肝衰竭,接受了肝细胞移植作为全器官再次移植的桥梁。在肝细胞移植后及入住重症监护病房期间,在每次肝细胞输注前后,分别每12小时和24小时进行血液检查并测定血氨水平。

结果

本研究描述了肝细胞移植后分析和临床参数的监测以及肝功能的改善。在两名患者中,我们成功降低了血氨水平,并在临床上改善了肝性脑病的程度,从而使1例患者成功接受了再次肝移植。

结论

我们认为,这种治疗方法可能是慢性肝病患者急性失代偿发作时的一种替代治疗方法,可作为传统肝移植的桥梁。

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