Please use this identifier to cite or link to this item: http://www.arca.fiocruz.br/handle/icict/8988
Title: Infusion of autologous bone marrow mononuclear cells through hepatic artery results in a short-term improvement of liver function in patients with chronic liver disease: a pilot randomized controlled study.
Authors: Lyra, Andre Castro
Soares, Milena Botelho Pereira
Silva, Luiz Flavio Maia da
Braga, Eduardo Lorens
Oliveira, Sheilla Andrade de
Fortes, Marcos Fraga
Silva, André Goyanna Pinheiro
Brustolim, Daniele
Genser, Bernd
Santos, Ricardo Ribeiro dos
Lyra, Luiz Guilherme Costa
Affilliation: Hospital Sao Rafael. Salvador, BA, Brasil / Hospital Universitário Professor Edgard Santos. Federal Univeristy of Bahia. Medicine-Gastro-Hepatology Service. Salvador, BA, Brasil
Hospital São Rafael. Regenerative Medicine. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Hospital Sao Rafael. Medicine. Hematology. Salvador, BA, Brasil
Hospital Sao Rafael. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Hospital São Rafael. Radiology. Salvador, BA, Brasil
Hospital São Rafael. Regenerative Medicine. Salvador, BA, Brasil
BGStats Consulting. Graz, Austria
Hospital São Rafael. Regenerative Medicine. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Hospital Sao Rafael. Salvador, BA, Brasil
Abstract: AIM: This randomized controlled study evaluated the effect of autologous infusion of bone marrow cells (BMC) in patients with hepatic cirrhosis. METHODS: Thirty patients on the liver transplant waiting list were randomly assigned to receive BMC therapy or no treatment. They were followed up for 1 year. The study was nonblinded. Autologous mononuclear-enriched BMC were infused into the hepatic artery; liver function scores/tests were chosen as endpoints to assess efficacy. Statistical analysis calculated mean relative changes (RC) from baseline and fitted a random-effects model. RESULTS: Mean age, baseline model for end-stage liver disease, and Child-Pugh score were similar in both groups. Child-Pugh score improved in the first 90 days in the cell therapy group compared with controls (P = 0.017, BMC group RC = -8%, controls RC = +5%). The model for end-stage liver disease score remained stable in the treated patients (RC -2 to +6%), whereas it increased during follow-up in the control group (RC +6 to +18%). Albumin levels improved in the treatment arm, whereas they remained stable among controls in the first 90 days (P = 0.034; BMC group RC = +16%, control group RC = +2%). Bilirubin levels increased among controls, whereas they decreased in the therapy arm during the first 60 days; INR RC differences between groups reached up to 10%. The changes observed did not persist beyond 90 days. CONCLUSION: Transplantation of autologous BMC into the hepatic artery improved liver function in patients with advanced cirrhosis in the first 90 days. However, larger studies are necessary to define the role of BMC therapy in cirrhotic patients. Repeated autologous BMC infusions or combination therapy with granulocyte-colony-stimulating factor might improve or sustain the treatment response.
Keywords: Bone marrow stem cell transplantation
CD34+
Cell therapy
Chronic liver disease
Cirrhosis
DeCS: Transplante de Medula Óssea/métodos
Cirrose Hepática/terapia
Adolescente
Adulto
Idoso
Bilirrubina/sangue
Doença Crônica
Métodos Epidemiológicos
Feminino
Artéria Hepática
Humanos
Cirrose Hepática/sangue
Transplante de Fígado
Masculino
Meia-Idade
Tempo de Protrombina
Albumina Sérica/metabolismo
Listas de Espera
Adulto Jovem
Issue Date: 2010
Publisher: Lippincott Williams & Wilkins
Citation: LYRA, A. C. et al. Infusion of autologous bone marrow mononuclear cells through hepatic artery results in a short-term improvement of liver function in patients with chronic liver disease: a pilot randomized controlled study. European Journal of Gastroenterology & Hepatology, v. 22, n. 1, p. 33-42, 2010
ISSN: 1473-5687
Copyright: open access
Appears in Collections:IGM - Artigos de Periódicos

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