Andreone Pietro, Catani Lucia, Margini Cristina, Brodosi Lucia, Lorenzini Stefania, Sollazzo Daria, Nicolini Benedetta, Giordano Rosaria, Montemurro Tiziana, Rizzi Simonetta, Dan Elisa, Giudice Valeria, Viganò Mariele, Casadei Andrea, Foschi Francesco G, Malvi Deborah, Bernardi Mauro, Conti Fabio, Lemoli Roberto M
Department of Medical and Surgical Sciences, Bologna University, Bologna, Italy.
Department of Specialty Diagnostic and Experimental Medicine, Bologna University, Bologna, Italy.
Dig Liver Dis. 2015 Dec;47(12):1059-66. doi: 10.1016/j.dld.2015.08.018. Epub 2015 Sep 10.
Bone marrow stem/progenitor cells seem to be effective in liver regeneration after tissue injury.
To evaluate the feasibility and safety of the mobilization and reinfusion of CD133+ stem/progenitor cells in patients with end-stage liver disease.
Autologous CD133+ stem/progenitor cells, mobilized with granulocyte-colony stimulating factor, were collected by leukapheresis and reinfused at increasing doses through the hepatic artery starting from 5×10(4)/kg up to 1×10(6)/kg.
16 subjects with Model for End-stage Liver Disease (MELD) score between 17 and 25 were enrolled, 14 mobilized an adequate number of CD133+ stem/progenitor cells and 12 were reinfused. No severe adverse events related to the procedure were reported. MELD score significantly worsened during mobilization in Child Turcotte Pugh-C patients. A significant improvement of liver function was observed 2 months after reinfusion (MELD 19.5 vs. 16; P=0.045). Overall, 5 patients underwent liver transplantation within 12 months from reinfusion and 2 died because of progressive liver failure.
CD133+ stem/progenitor cells reinfusion in patients with end-stage liver disease is feasible and safe. A worsening of liver function was observed during mobilization in Child Turcotte Pugh-C patients. The temporary improvement of MELD score after reinfusion suggests that stem cells therapy may be a "bridge to transplant" approach for these patients.
骨髓干/祖细胞似乎在组织损伤后的肝脏再生中有效。
评估动员和回输CD133⁺干/祖细胞治疗终末期肝病患者的可行性和安全性。
采用粒细胞集落刺激因子动员自体外周血CD133⁺干/祖细胞，通过白细胞分离术采集，然后经肝动脉以递增剂量回输，起始剂量为5×10⁴/kg，最高至1×10⁶/kg。
纳入16例终末期肝病模型（MELD）评分在17至25分之间的患者，14例成功动员出足够数量的CD133⁺干/祖细胞，其中12例接受了回输。未报告与该操作相关的严重不良事件。Child Turcotte Pugh - C级患者在动员过程中MELD评分显著恶化。回输2个月后观察到肝功能有显著改善（MELD评分从19.5降至16；P = 0.045）。总体而言，5例患者在回输后12个月内接受了肝移植，2例因进行性肝衰竭死亡。
终末期肝病患者回输CD133⁺干/祖细胞是可行且安全的。Child Turcotte Pugh - C级患者在动员过程中观察到肝功能恶化。回输后MELD评分的暂时改善表明干细胞治疗可能是这些患者的一种“移植桥梁”方法。
