Umbilical Cord-Derived Mesenchymal Stem Cell Transplantation in Hepatitis B Virus Related Acute-on-Chronic Liver Failure Treated with Plasma Exchange and Entecavir: a 24-Month Prospective Study

Li, Yuhua; Xu, Ying; Wu, Hua‐Mei; Yang, Jing; Yang, Lihong; Wan, Yue-Meng

doi:10.1007/s12015-016-9683-3

Cited by 70 publications

(77 citation statements)

References 32 publications

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“…TPE was performed according to the requirements and procedures described in our previous studies . In brief, a double‐lumen catheter was inserted into the femoral or internal jugular vein of patients.…”

Section: Methodsmentioning

confidence: 99%

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Therapeutic plasma exchange versus double plasma molecular absorption system in hepatitis B virus‐infected acute‐on‐chronic liver failure treated by entercavir: A prospective study

Wan

et al. 2017

J of Clinical Apheresis

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Section: Methodsmentioning

confidence: 99%

“…TPE was performed according to the requirements and procedures described in our previous studies. 13,16 In brief, a double-lumen catheter was inserted into the femoral or internal jugular vein of patients. TPE was performed with plasma separator multifiltrate 3MUG7581 (Fresenius Medical Care AG & Co.KGAa, Furth Germany).…”

Section: Tpementioning

confidence: 99%

Therapeutic plasma exchange versus double plasma molecular absorption system in hepatitis B virus‐infected acute‐on‐chronic liver failure treated by entercavir: A prospective study

Wan

et al. 2017

J of Clinical Apheresis

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“…55 Moreover, in a small trial, the combination of umbilical cord-derived mesenchymal stem cell infusions and PE improved outcomes of HBV-related ACLF compared to PE alone. 56 Faecal microbiota transplantation Based on the hypothesis that bacterial intestinal dysbiosis/translocation is a contributing factor for ACLF, a small pilot study on healthy donor faecal microbiota transplantation in eight patients with sAH who were ineligible for corticosteroids showed an improvement in liver parameters and a better one-year survival rate compared to historical controls. 57 Back to the clinical case The patient was admitted to the hospital with AD without ACLF (according to EASL-CLIF criteria) triggered by spontaneous bacterial peritonitis.…”

Section: Cell Therapymentioning

confidence: 99%

Acute-on-chronic liver failure vs. traditional acute decompensation of cirrhosis

Gustot

Moreau

2018

Journal of Hepatology

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Clinical vignette A 34-year-old woman with a history of chronic HCV-related cirrhosis was admitted to the hospital emergency department for an acute decompensation characterised by jaundice and ascites. A diagnosis of community-acquired spontaneous bacterial peritonitis complicated by bacteraemia with Escherichia coli was made. Despite prompt, adequate antibiotic treatment (ceftriaxone for 7 days), albumin infusion and adequate response (decrease of at least 25% of ascitic neutrophils at 48 h after the start of antibiotic), physicians observed a severe clinical deterioration with the development of neurological and respiratory failure. The patient was referred to the intensive care unit of University Hospital. At admission, the patient was mechanically ventilated with severe respiratory parameters (low tidal volume, positive end expiratory pressure [PEEP] of 15 cm H 2 O and fractional inspired oxygen [FiO 2 ] 50%, resulting in arterial oxygen partial pressure [PaO 2 ] of 61 mmHg, PaO 2 /FiO 2 ratio of 122), stage IV hepatic encephalopathy, type I hepatorenal syndrome that responded to terlipressin 4 mg per day (creatinine 1.1 mg/dl), international normalized ratio (INR) 3.58, and total bilirubin 22 mg/dl. Thoracic computed tomography showed slight bilateral pleural effusion and left basal condensation. A systematic microbiological screening including bronchoalveolar lavage, blood, urinary and ascitic cultures did not demonstrate any overt infection. After three days of intensive management, the clinical situation did not improve significantly (mechanical ventilation with PEEP 12 cmH 2 O, FiO 2 50%, PaO 2 65 mmHg and a PaO 2 /FiO 2 ratio of 130, stage IV hepatic encephalopathy, serum ammonia level of 376 lg/dl, INR 2.98, total bilirubin 30 mg/dl, creatinine 0.9 mg/dl under terlipressin 4 mg per day). Thus, orthotopic liver transplantation was considered the only long-term life-saving option for this patient. However, this candidate seemed to be too sick to receive an organ. This case prompts many clinical questions, including: I. Are there specificities in this acute decompensation of cirrhosis? Is the concept of ACLF relevant for this case? II. Which precipitating events and pathogenic mechanisms are responsible for ACLF? III. Do we have tools to predict outcomes and clinical courses for ACLF? IV. What are the current management strategies, supported by evidence, for patients with ACLF? V. Is salvage liver transplantation a reasonable therapeutic option for ACLF? What is the ideal timing for liver transplantation? VI. Are there therapeutic (including experimental) strategies to improve survival or to bridge the patient to liver transplantation?

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“…Patients with HBV related acute-on-chronic liver failure (HBV-ACLF) received plasma exchange, entecavir and a single transplantation of umbilical cord-derived MSC (UC-MSC) transplantation (100 × 10 6 cell suspension via the hepatic artery) compared to another group which received only plasma exchange and entecavir. Notably, an improvement in liver function tests and higher cumulative survival rate at 24 months have been observed in the patient groups who were transplanted with UC-MSC [ 123 ].…”

Section: Potential Cell Sources To Treat Liver Diseasementioning

confidence: 99%

Liver cell therapy: is this the end of the beginning?

Alwahsh

Rashidi

Hay

2017

Cell. Mol. Life Sci.

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The prevalence of liver diseases is increasing globally. Orthotopic liver transplantation is widely used to treat liver disease upon organ failure. The complexity of this procedure and finite numbers of healthy organ donors have prompted research into alternative therapeutic options to treat liver disease. This includes the transplantation of liver cells to promote regeneration. While successful, the routine supply of good quality human liver cells is limited. Therefore, renewable and scalable sources of these cells are sought. Liver progenitor and pluripotent stem cells offer potential cell sources that could be used clinically. This review discusses recent approaches in liver cell transplantation and requirements to improve the process, with the ultimate goal being efficient organ regeneration. We also discuss the potential off-target effects of cell-based therapies, and the advantages and drawbacks of current pre-clinical animal models used to study organ senescence, repopulation and regeneration.

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Umbilical Cord-Derived Mesenchymal Stem Cell Transplantation in Hepatitis B Virus Related Acute-on-Chronic Liver Failure Treated with Plasma Exchange and Entecavir: a 24-Month Prospective Study

Abstract: UC-MSC transplantation is safe and effective for HBV-ACLF patients treated with PE and entecavir. It further improves the hepatic function and survival.

Cited by 70 publications

References 32 publications

Therapeutic plasma exchange versus double plasma molecular absorption system in hepatitis B virus‐infected acute‐on‐chronic liver failure treated by entercavir: A prospective study

Therapeutic plasma exchange versus double plasma molecular absorption system in hepatitis B virus‐infected acute‐on‐chronic liver failure treated by entercavir: A prospective study

Acute-on-chronic liver failure vs. traditional acute decompensation of cirrhosis

Liver cell therapy: is this the end of the beginning?

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