Zheng Shao-Peng, Deng Ao-Jian, Zhou Jing-Jing, Yuan Ling-Zhi, Shi Xiao, Wang Fen
Department of Gastroenterology, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China.
Hunan Key Laboratory of Non-resolving Inflammation and Cancer, Central South University, Changsha 410000, Hunan Province, China.
World J Gastrointest Surg. 2023 Apr 27;15(4):655-663. doi: 10.4240/wjgs.v15.i4.655.
Recently, stem cell therapy has been extensively studied as a promising treatment for decompensated liver cirrhosis (DLC). Technological advances in endoscopic ultrasonography (EUS) have facilitated EUS-guided portal vein (PV) access, through which stem cells can be precisely infused.
To investigate the feasibility and safety of fresh autologous bone marrow injection into the PV under EUS guidance in patients with DLC.
Five patients with DLC were enrolled in this study after they provided written informed consent. EUS-guided intraportal bone marrow injection with a 22G FNA needle was performed using a transgastric, transhepatic approach. Several parameters were assessed before and after the procedure for a follow-up period of 12 mo.
Four males and one female with a mean age of 51 years old participated in this study. All patients had hepatitis B virus-related DLC. EUS-guided intraportal bone marrow injection was performed in all patients successfully without any complications such as hemorrhage. The clinical outcomes of the patients revealed improvements in clinical symptoms, serum albumin, ascites, and Child-Pugh scores throughout the 12-mo follow-up.
The use of EUS-guided fine needle injection for intraportal delivery of bone marrow was feasible and safe and appeared effective in patients with DLC. This treatment may thus be a safe, effective, non-radioactive, and minimally invasive treatment for DLC.
最近，干细胞疗法作为失代偿期肝硬化（DLC）的一种有前景的治疗方法受到了广泛研究。内镜超声检查（EUS）技术的进步促进了EUS引导下的门静脉（PV）穿刺，通过该穿刺可以精确注入干细胞。
探讨在EUS引导下对DLC患者进行新鲜自体骨髓注入PV的可行性和安全性。
5例DLC患者在提供书面知情同意书后纳入本研究。采用经胃、经肝途径，使用22G FNA针在EUS引导下进行门静脉内骨髓注射。在术后12个月的随访期内，对几个参数进行了术前和术后评估。
4例男性和1例女性参与本研究，平均年龄51岁。所有患者均为乙型肝炎病毒相关性DLC。所有患者均成功进行了EUS引导下的门静脉内骨髓注射，未出现出血等并发症。患者的临床结果显示，在整个12个月的随访期间，临床症状、血清白蛋白、腹水和Child-Pugh评分均有改善。
使用EUS引导下细针注射进行门静脉内骨髓输送对DLC患者是可行、安全的，且似乎有效。因此，这种治疗可能是一种安全、有效、无放射性且微创的DLC治疗方法。
