title: No evidence of hematopoietic stem cell mobilization in patients submitted to hepatectomy or in patients with acute on chronic liver failure.
abstract: BACKGROUND
  Liver regeneration is a heterogeneous phenomenon involving the proliferation of different cell lineages in response to injury. Under a strong positive selection pressure bone marrow derived stem cells may be involved in this process, by making a contribution to both parenchymal restoration and endothelial cell replacement. We investigate bone marrow stem cell migration to the liver in patients undergoing hepatectomy or with acute on chronic liver failure.
  
  
  METHODS
  We enrolled 6 patients submitted to hepatectomy, 6 patients to cholecystectomy and 8 patients with acute decompensation of liver cirrhosis. Mobilization of CD34+ cells was evaluated by cytofluorimetry on peripheral blood samples at different time points; baseline, 1, 3, 7, 15 and 30 days after surgery and at admission, 1, 7 and discharge among patients with acute on chronic liver failure. 10 healthy subjects undergoing blood donation were also enrolled to evaluated the basal value of CD34+ cells.
  
  
  RESULTS
  White blood cell counts remained in the normal range (4.1-9.8 x 10(9)/L) in all groups throughout the follow-up. In all patients of Groups 1, 2 and 3, circulating CD34+ failed to show statistically significant differences both as the absolute number and as the percentage at any time point compared to healthy controls.
  
  
  CONCLUSIONS
  Bone marrow derived cell mobilization can not be detected after hepatectomy or during an acute decompensation on a cirrhotic liver. Under these circumstances liver regeneration can probably call upon mature hepatocytes and endogenous progenitor cells. The involvement of extrahepatic progenitors if any, is a rare and limited phenomenon.
authors.affiliation: Department of Medical Pathology, Hepato-Biliary Surgery Unit, Catholic University of Rome, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Di Campli
authors.forename: A C
authors.initials: AC
authors.lastname: Piscaglia
authors.forename: F
authors.initials: F
authors.lastname: Giuliante
authors.forename: S
authors.initials: S
authors.lastname: Rutella
authors.forename: G
authors.initials: G
authors.lastname: Bonanno
authors.forename: M A
authors.initials: MA
authors.lastname: Zocco
authors.forename: F
authors.initials: F
authors.lastname: Ardito
authors.forename: G
authors.initials: G
authors.lastname: Nuzzo
authors.forename: S
authors.initials: S
authors.lastname: Mancuso
authors.forename: G
authors.initials: G
authors.lastname: Leone
authors.forename: G
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: P
authors.initials: P
authors.lastname: Pola
authors.forename: A
authors.initials: A
authors.lastname: Gasbarrini
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000097:blood; D018952:Antigens, CD34 / Q000097:blood; D001772:Blood Cell Count; D002763:Cholecystectomy; D002908:Chronic Disease; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006498:Hepatectomy; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D017114:Liver Failure, Acute / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D008875:Middle Aged
chemical_list: D015703:Antigens, CD; D018952:Antigens, CD34