Phase 1 human trial of autologous bone marrow-hematopoietic stem cell transplantation in patients with decompensated cirrhosis

To evaluate safety and feasibility of autologous bone marrow-enriched CD34+ hematopoietic stem cell Tx through the hepatic artery in patients with decompensated cirrhosis. Four patients with decompensated cirrhosis were included. Approximately 200 mL of the bone marrow of the patients was aspirated,...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2007-06, Vol.13 (24), p.3359-3363
Main Authors: Mohamadnejad, Mehdi, Namiri, Mehrnaz, Bagheri, Mohamad, Hashemi, Seyed Masiha, Ghanaati, Hossein, Zare Mehrjardi, Narges, Kazemi Ashtiani, Saeed, Malekzadeh, Reza, Baharvand, Hossein
Format: Article
Language:English
Subjects:
Adult
Antigens, CD34 - analysis
Bone Marrow Cells - cytology
Cell Survival
Female
Hematopoietic Stem Cell Transplantation
Hepatic Artery
Humans
Liver Cirrhosis - therapy
Male
Middle Aged
Rapid Communication
Transplantation, Autologous
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Summary:To evaluate safety and feasibility of autologous bone marrow-enriched CD34+ hematopoietic stem cell Tx through the hepatic artery in patients with decompensated cirrhosis. Four patients with decompensated cirrhosis were included. Approximately 200 mL of the bone marrow of the patients was aspirated, and CD34+ stem cells were selected. Between 3 to 10 million CD34+ cells were isolated. The cells were slowly infused through the hepatic artery of the patients. Patient 1 showed marginal improvement in serum albumin and no significant changes in other test results. In patient 2 prothrombin time was decreased; however, her total bilirubin, serum creatinine, and Model of End-Stage Liver Disease (MELD) score worsened at the end of follow up. In patient 3 there was improvement in serum albumin, porthrombin time (PT), and MELD score. Patient 4 developed radiocontrast nephropathy after the procedure, and progressed to type 1 hepatorenal syndrome and died of liver failure a few days later. Because of the major side effects seen in the last patient, the trial was prematurely stopped. Infusion of CD34+ stem cells through the hepatic artery is not safe in decompensated cirrhosis. Radiocontrast nephropathy and hepatorenal syndrome could be major side effects. However, this study does not preclude infusion of CD34+ stem cells through other routes.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v13.i24.3359