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Rationale and prospects of mesenchymal stem cell therapy for liver transplantation

Obermajer, Natašaa; Popp, Felix C.b; Johnson, Christian L.b; Benseler, Volkerb; Dahlke, Marc H.b

Current Opinion in Organ Transplantation: February 2014 - Volume 19 - Issue 1 - p 60–64
doi: 10.1097/MOT.0000000000000031
STEM CELL TRANSPLANTATION: Edited by Giuseppe Remuzzi

Purpose of review: Despite their potential to supplement the donor organ pool, expanded donor criteria grafts are associated with an elevated risk of graft failure and increased early mortality. Likewise, attempts to promote operational graft tolerance through conventional immunosuppressive therapy have demonstrated significant safety-related drawbacks. Because of their potent regenerative and immunomodulative potential, adjunct mesenchymal stem cell (MSC) therapy represents an innovative approach to both of these clinical problems.

Recent findings: Recent studies have begun to delineate the benefit and mechanisms of short-term therapy combining MSCs and low-dose immunosuppressive drugs in promoting graft acceptance and potentially regeneration.

Summary: The current review presents our rationale for the first-in-man clinical trial in liver transplantation utilizing a mesenchymal cell product (MultiStem, Athersys, Cleveland, Ohio, USA). The long-term objective of this program is to safely minimize the dose of complementary immunosuppressive drugs while achieving long-term allograft survival and operational tolerance. The use of adjunct cellular therapy as a means of reducing long-term pharmacotherapy would represent a major advancement in the field of liver transplantation.

aDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

bDepartment of Surgery, University Hospital Regensburg, Regensburg, Germany

Correspondence to Marc H. Dahlke, MD, PhD, Department of Surgery, University Hospital Regensburg, Franz Josef Strauss Allee 11, 93053 Regensburg, Germany. Tel: +49 941 944 6812; fax: +49 941 944 6858; e-mail: marc.dahlke@ukr.de

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