Autologous Peripheral Blood Stem Cell Transplantation Improves Portal Hemodynamics in Patients with Hepatitis B Virus-related Decompensated Cirrhosis

Abstract

Background:Chronic hepatitis B virus (HBV) infection may eventually lead to decompensated liver cirrhosis, which is a terminal illness.Objectives:The aim of this study was to investigate the therapeutic efficacy of autologous peripheral blood stem cell (APBSC) transplantation to improve portal vein hemodynamics in patients with HBV-related decompensated cirrhosis.Patients and Methods:This prospective study included 68 hospitalized patients who were diagnosed with HBV-related decompensated cirrhosis. These patients were divided into two groups: the transplantation group included 33 patients, while the control group included 35. Both groups received conventional medical treatment simultaneously, and APBSC transplantation was performed on the patients in the transplantation group. We evaluated the effects of APBSC transplantation on postoperative liver function using the following indices: total bilirubin, serum prothrombin and albumin, spleen size, and portal vein hemodynamics. Postoperatively, all of the patients were followed up at 24, 36, and 48 weeks.Results:The transplantation group had no serious reactions. Compared with the control group, albumin and prothrombin activity in the transplantation group was significantly improved at 24, 36, and 48 weeks after the procedure, and spleen length and portal vein diameter were substantially reduced at 48 weeks. The velocity of peak portal vein blood flow and mean maximum portal vein blood flow were greatly increased in the APBSC transplantation group at 36 and 48 weeks, respectively; however, there was also decreased portal vein diameter, which reduced portal vein pressure in patients with HBV-related decompensated cirrhosis.Conclusions:APBSC transplantation greatly benefits HBV-linked decompensated cirrhosis patients and should be recommended in clinical practice.

Therapeutic effect and safety of stem cell therapy for chronic liver disease: a systematic review and meta-analysis of randomized controlled trials

“…Five studies [ 27 , 32 , 35 , 37 , 39 ] reported that there were no procedural complications after cell infusion, while thirteen studies [ 20 – 22 , 24 – 26 , 28 , 31 , 33 , 36 , 38 , 40 , 43 ] reported adverse events of stem cell therapy, including fever, transient shivering, local pain, ecchymosis/hematoma, rash, diarrhea, chest tightness, and constipation, most of which resolved spontaneously (Additional file 5 : Table S3).…”

Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis

“…Etiology-based analysis of the studies revealed the following: patients with only severe alcoholic hepatitis ( n = 1 study) [ 47 ]; patients with ESLD due to hepatitis C virus (HCV) infection ( n = 1 study) [ 40 ]; patients with only hepatitis B virus (HBV)‒associated ESLD ( n = 5 studies) [ 42 – 46 ]; ESLD patients with hepatitis B virus (HBV) or alcoholic hepatitis ( n = 1 study) [ 41 ]. Analysis of the frequency of stem cell injections revealed the following: single stem cell injections ( n = 6 studies) [ 40 – 43 , 45 , 46 ]; two spaced stem cell injections ( n = 1 study) [ 44 ]; a mix of single and two stem cell injections ( n = 1 study) (Table 1 ) [ 47 ].…”

“…The studies selected for this review included eight prospective interventional studies ( n = 579 patients), including four randomized controlled trials ( n = 303 patients) [ 43 – 45 , 47 ], four non-randomized controlled trials ( n = 276 patients) [ 40 – 42 , 46 ], and one study clearly stating the blindedness of the outcome evaluators [ 43 ]. Two studies were deemed to have a high risk of attrition bias as the participants were lost to follow-up [ 43 , 47 ]. A symmetric funnel plot that illustrates the absence of publication bias is shown in Fig.…”

“…After extracting data from the eight included studies, two subgroup analysis were performed for factors that were thought to influence the outcomes. With respect to the number of injection cycles of stem cells, six studies [ 40 – 43 , 45 , 46 ] focused on single injection, one study [ 44 ] on two injections, and one study [ 47 ] focused on the effects of both single and two injections. Regarding the species of adult stem cells, CD34 + APBSCs were transplanted in two studies [ 42 , 43 ], MNCs were transplanted in two studies [ 40 , 41 ], and autologous BMMSCs were used in two studies [ 46 , 47 ].…”

The Clinical Outcomes of Stem Cell Therapy for Decompensated Liver Disease: A Systematic Review and Meta-Analysis

“…The publications involved may not be comprehensive enough to cover all related articles. In addition, it is hard to ignore some factors included in the studies, such as the various etiology and severity of the hepatic disease, the age of the enrolled patients (for that the older patients may have a lower capacity to improve liver function) [7][8][9][10][11] . Importantly, the studies which used different cells via diverse injection routes were pooled together.…”