New alternatives to the treatment of acute liver failure.
BACKGROUND
Acute-on-chronic liver failure (ACLF) is defined as an acute deterioration of a chronic liver disease. The most effective treatment in these patients is orthotopic liver transplantation (OLT), which is highly limited by the donor shortage. The aim of this study was to increase the usefulness of hepatocyte transplantation (HT) as a bridge or alternative to OLT.


METHODS
During the last 2 years, we have performed HT in 3 patients with ACLF. The diagnosis was graft cirrhosis due to hepatitis C virus in 2 of them, who were already included on waiting lists for retransplantation, and the third, unknown alcoholic cirrhosis.


RESULTS
After the first HT infusion, we observed an improvement in the clinical condition in all patients, hyperammonemia, and a partial correction of the degree of encephalopathy; 1 patient was retransplanted 6 days after the first HT.


CONCLUSIONS
The main indications for HT are inborn errors of metabolism in children. Other indications especially in adults, are acute liver failure, ACLF in patients with end-stage-liver disease who are a waiting OLT, and acute liver failure after an hepatectomy. HT may be a new treatment to improve the clinical condition in patients awaiting OLT.
Unidad de Cirugía Hepatobiliopancreática y Trasplante Hepático, Hospital La Fe, Valencia, Spain. pareja_eug@gva.es
E
E
Pareja
M
M
Cortes
A
A
Bonora
P
P
Fuset
F
F
Orbis
R
R
Lopez
J
J
Mir
D000328:Adult; D017690:Cell Transplantation; D022781:Hepatocytes / Q000166:cytology*; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged