Feasibility and safety of autologous bone marrow mononuclear cell transplantation in patients with advanced chronic liver disease.
OBJECTIVE
To evaluate the safety and feasibility of bone marrow cell (BMC) transplantation in patients with chronic liver disease on the waiting list for liver transplantation.


METHODS
Ten patients (eight males) with chronic liver disease were enrolled to receive infusion of autologous bone marrow-derived cells. Seven patients were classified as Child-Pugh B and three as Child-Pugh C. Baseline assessment included complete clinical and laboratory evaluation and abdominal MRI. Approximately 50 mL of bone marrow aspirate was prepared by centrifugation in a ficoll-hypaque gradient. At least of 100 millions of mononuclear-enriched BMCs were infused into the hepatic artery using the routine technique for arterial chemoembolization for liver tumors. Patients were followed up for adverse events up to 4 mo.


RESULTS
The median age of the patients was 52 years (range 24-70 years). All patients were discharged 48 h after BMC infusion. Two patients complained of mild pain at the bone marrow needle puncture site. No other complications or specific side effects related to the procedure were observed. Bilirubin levels were lower at 1 (2.19 +/- 0.9) and 4 mo (2.10 +/- 1.0) after cell transplantation that baseline levels (2.78 +/- 1.2). Albumin levels 4 mo after BMC infusion (3.73 +/- 0.5) were higher than baseline levels (3.47 +/- 0.5). International normalized ratio (INR) decreased from 1.48 (SD = 0.23) to 1.43 (SD = 0.23) one month after cell transplantation.


CONCLUSIONS
BMC infusion into hepatic artery of patients with advanced chronic liver disease is safe and feasible. In addition, a decrease in mean serum bilirubin and INR levels and an increase in albumin levels are observed. Our data warrant further studies in order to evaluate the effect of BMC transplantation in patients with advanced chronic liver disease.
Lyra
Andre Castro
AC
Hospital Sao Rafael, Salvador, Bahia, Brazil. aclyra@atarde.com.br
Soares
Milena Botelho Pereira
MB
da Silva
Luiz Flavio Maia
LF
Fortes
Marcos Fraga
MF
Silva
André Goyanna Pinheiro
AG
Mota
Augusto César de Andrade
AC
Oliveira
Sheilla A
SA
Braga
Eduardo Lorens
EL
de Carvalho
Wilson Andrade
WA
Genser
Bernd
B
dos Santos
Ricardo Ribeiro
RR
Lyra
Luiz Guilherme Costa
LG
D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods*; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008107:Liver Diseases / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D008115:Liver Regeneration / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism
D012709:Serum Albumin; D001663:Bilirubin