Liver transplantation is universally accepted as a “cure” procedure, and yet is not universally applicable for the treatment of end-stage liver diseases (ESLD) because of the shortage of donors, operative complications, risk of rejection, and high cost. Bioartificial liver device is an option to temporarily improve the liver function and to bridge the patients to liver transplantation. However, bioartificial liver device has many problems in clinical application, such as hepatocyte allograft rejection and maintenance of hepatocyte viability and function. Another therapeutic option is stem cell transplantation. There are two broad types of stem cells: Embryonic stem cells and adult stem cells. The latter are sourced from bone marrow (BM), adipose tissue, and blood. This review will concentrate on BM-derived cells. BM-derived cell transplantation, although not ideal, is theoretically an optimal modality for the treatment of ESLD. Autologous BM-derived cells have no graft rejection, have the capability of regeneration and self-renewal, and are multipotent stem cells that can differentiate into a variety of cell types which include hepatocytes. The pathway from BM-derived cell to hepatocyte is well documented. The present review summarizes the delivery routes of BM-derived cells to the liver, the evidences of engraftment of BM-derived cells in the liver, and the possible mechanisms of BM-derived cells in liver repair and regeneration, and finally, updates the clinical applications.
Usually, malignant high blood pressure and severe renal damage are main characters in SSc. SRCs is a relatively rare condition, found in approximately 5% of all SSc patients. This study was carried out to summarize the contemporary evidence regarding the causes, risk factors, manifestations, management and prognosis of Sclerodermal Renal Crisis. a simple review was carried out, searching databases PubMed, Google Scholar, and EBSCO. The authors extracted the needed data and stated that SRCs continues to be a rare diagnosis affecting up to six percent of SSc patients, but has a high morbidity and death influence. SRCs presentation is varied, with hypertension, normal BP and renal insufficiency. Medics should be minded by potential SRCs presentations. Early detection and initiation of aggressive ACEi antihypertensive medication in ED could enhance patient outcomes and around 60% of SRCs patients need dialysis.
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