End-stage liver disease is a medical problem with high morbidity and mortality. We have investigated the feasibility, safety, and efficacy of using autologous mesenchymal stem cells (MSCs) as a treatment.
Eight patients (four hepatitis B, one hepatitis C, one alcoholic, and two cryptogenic) with end-stage liver disease having Model for End-Stage Liver Disease score ≥10 were included. Autologous MSCs were taken from iliac crest. Approximately, 30–50 million MSCs were proliferated and injected into peripheral or the portal vein. Liver function and clinical features were evaluated at baseline and 1, 2, 4, 8, and 24 weeks after injection.
Treatment was well tolerated by all patients. Liver function improved as verified by the Model for End-Stage Liver Disease score, which decreased from 17.9±5.6 to 10.7±6.3 (P<0.05) and prothrombin complex from international normalized ratio 1.9±0.4 to 1.4±0.5 (P<0.05). Serum creatinine decreased from 114±35 to 80±18 μmol/l (P<0.05). Serum albumin changed from 30±5 to 33±5 g/l and bilirubin from 46±29 to 41±31 μmol/l. No adverse effects were noted.
Our data show that MSCs injection can be used for the treatment of end-stage liver disease with satisfactory tolerability. Furthermore, this treatment may improve clinical indices of liver function in end-stage liver disease.
aUrology and Nephrology Research Center (UNRC)
cResearch Center of Gastroenterology and Liver Disease, Shahid Beheshti University of MC
dCell Biology Department, Stem Cell Technology Company
eDepartment of Hematology, Faculty of Medical Sciences, Tarbiat Modarres University, Tehran, Iran
fDepartment of Medicine, Gastroenterology Unit, Karolinska Institutet, Stockholm, Sweden, Karolinska University Hospital Solna, Sweden
Correspondence to Professor Per M. Hellström, MD, PhD, Gastrocentre Medicine, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
Tel: +46 8 5177 3177; fax: +46 8 5177 1100; e-mail: Per.Hellstrom@ki.se
Received 8 December 2008 Accepted 29 January 2009