[Transplantation of isolated hepatocytes, is it an alternative for total liver transplantation? On the treatment of hereditary hepatic metabolic diseases].
Since 1976, it has been demonstrated in the small animal that isolated hepatocytes transferred into the liver can integrate into the recipient organ, survive and perform differentiated functions. This cell therapy technique can be used to partially correct for hereditary metabolic disorders in animal models of human hereditary metabolic diseases. The first methods used for hepatocytes transplantation involved a mass of hepatocytes that was clearly to limited (about 0.5% and never more than 2%). Integration fo the hepathocytes was limited by poorly understood factors. The vary variable clinicial results in the eight trials performed in the 90s is a clear demonstration. Recent work has helped understand the mechanisms limiting the integration of transplanted hepatocytes in the recipient liver. This led to the concept of repopulation, increasing the percentage of the hepatocyte mass reconstituted during the transplantation. The goal is to give the transplanted hepatocytes a proliferation advantage over he native hepatocytes. Several models have been designed and are currently being evaluated for application in humans. We are not far from new clinical trials with hepatocyte transplantation in humans for the treatment hereditary metabolic diseases. For certain disease, 3 to 5% normally functioning hepatocytes in the recipient liver would be sufficient to achieve a clinically significant effect for the patient.
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Service de Chirurgie, Hôpital Antoine-Béclère, F92141 Clamart. corinne.vons@abc-hop-paris.fr
D000818:Animals; D017690:Cell Transplantation; D006801:Humans; D008099:Liver / Q000166:cytology*; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D008659:Metabolic Diseases / Q000150:complications / Q000601:surgery*