Autologous bone marrow infusion activates the progenitor cell compartment in patients with advanced liver cirrhosis.
Several clinical trials of bone marrow cell infusion in patients with liver cirrhosis (LC) have shown clinical improvement, despite conflicting results from animal models. We investigated serial pathological features and the clinical impact after autologous bone marrow infusion (ABMI) in patients with advanced LC. Ten patients with advanced LC due to chronic hepatitis B virus infection underwent ABMI. Serological tests, MRI, and liver biopsies were performed, and quality of life was assessed by a questionnaire. Median serum albumin and hemoglobin levels increased significantly after ABMI. All patients showed an improvement in quality of life, with no serious adverse events. Liver volume, measured by MRI, increased in 80% of the patients, and ascites decreased after ABMI. Child-Pugh scores were also significantly improved at 6 months after ABMI. In the serially biopsied livers, a gradually increasing activation of the hepatic progenitor cell (HPC) compartment, including HPC activation (ductular reaction) and HPC differentiation (intermediate hepatocyte), reached a peak after 3 months, with continued proliferation of hepatocytes, and returned to baseline levels after 6 months. There was no significant change in grade or stage of liver fibrosis or stellate cell activation after ABMI. ABMI is suggested to improve liver function and to activate the progenitor cell compartment. Although clinical improvement was sustained for more than 6 months, histological changes in the liver returned to baseline 6 months after ABMI. Further comparative studies are warranted.
Department of Internal Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
Ja Kyung
JK
Kim
Young Nyun
YN
Park
Jin Seok
JS
Kim
Mi-Suk
MS
Park
Yong Han
YH
Paik
Jae-Yeon
JY
Seok
Yong Eun
YE
Chung
Hyun Ok
HO
Kim
Kyung Sik
KS
Kim
Sang Hoon
SH
Ahn
Do Young
DY
Kim
Myeong-Jin
MJ
Kim
Kwan Sik
KS
Lee
Chae Yoon
CY
Chon
Soo Jeong
SJ
Kim
Shuji
S
Terai
Isao
I
Sakaida
Kwang-Hyub
KH
Han
D000328:Adult; D001854:Bone Marrow Cells / Q000166:cytology*; D016026:Bone Marrow Transplantation; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D013234:Stem Cells / Q000166:cytology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014182:Transplantation, Autologous