Controlled trials in hepatitis B virus-related decompensate liver cirrhosis: peripheral blood monocyte transplant versus granulocyte-colony-stimulating factor mobilization therapy.
BACKGROUND
Liver cirrhosis represents the end stage of chronic liver injury. Currently, liver transplantation provides the only definite cure but it is beset with many problems, including lack of donors and risk of rejection. Stem cell therapy is very attractive in this setting because it has the potential to help tissue regeneration. In this study, we aimed to investigate the therapeutic effect of peripheral blood monocyte cell (PBMC) transplantation in decompensated liver cirrhosis.


METHODS
A total of 40 subjects (31 men and nine females, age range 21-71 years) was recruited to two groups. Group 1 received granulocyte-colony-stimulating factor (G-CSF) mobilization, PBMC collection by leukapheresis and PBMC transplant therapy. Group 2 received G-CSF mobilization for 4 days. At baseline and 6 months after treatment, liver function of the two groups was monitored by blood examination and ultrasonagraphy.


RESULTS
Both groups gained significant improvement in liver synthetic function, such as serum albumin and prothrombin time, from baseline to 6 months after treatment (P<0.01). However, there was no significant difference in alanine aminotransferase, aspartate aminotransferase and total bilirubin in both groups (P>0.05). Compared with group 2, a significantly improved liver function was observed in group 1, including elevated serum albumin level and a decreased CTP score (P<0.05). No major adverse effects were noted.


CONCLUSIONS
Autologous PBMC transplantation could be considered as a novel and alternative treatment for patients with decompensated liver cirrhosis.
Department of Gastroenterology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, China.
Y
Y
Han
L
L
Yan
G
G
Han
X
X
Zhou
L
L
Hong
Z
Z
Yin
X
X
Zhang
S
S
Wang
J
J
Wang
A
A
Sun
Z
Z
Liu
H
H
Xie
K
K
Wu
J
J
Ding
D
D
Fan
D000328:Adult; D000368:Aged; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000276:immunology / Q000627:therapeutic use*; D006515:Hepatitis B virus / Q000235:genetics / Q000378:metabolism; D019694:Hepatitis B, Chronic / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008099:Liver / Q000473:pathology / Q000502:physiology; D008103:Liver Cirrhosis / Q000097:blood / Q000503:physiopathology / Q000628:therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000637:transplantation; D036102:Peripheral Blood Stem Cell Transplantation; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor