title: Autologous CD133+ cells augment the effect of portal embolization.
abstract: OBJECTIVE
  The standard to treat liver tumors is a resection. When the future liver remnant (FLRV) is below 30% (healthy livers) or 40% (cirrhotic livers or previous chemotherapy), surgery carries the risk of severe complications. Portal vein embolization (PVE) gained a worldwide diffusion as a tool to augment the FLRV. Cell therapies are recent players at the frontiers of medicine. This study presents a clinical experience to evaluate the synergistic effect of combined PVE and autologous CD133+ cells coadministration.
  
  
  METHODS
  Sixteen patients have been enrolled in the study up today. Inclusion criteria were: primary or metastatic liver malignancy with a FLRV<30% or 40%. A baseline volumetric CT-scan was obtained. CD34+ were mobilized to the blood stream by G-CSF administration and collected by immunomagnetic separation. Simultaneously with PVE, cells were administered to the non occluded liver segments. Follow-up CT scans were taken at 30th post treatment day.
  
  
  RESULTS
  The patients (N.=6) showed an increased volume gain (Mann-Whitney test P<0.001, two sided) compared to a set of cases whose treatment was PVE only (N.=10).
  
  
  CONCLUSIONS
  The use of autologous stem cells as an augmenter of liver regeneration has a clinical potential to improve the resectability of liver tumors.
authors.affiliation: Department of General Surgery I, University of Pavia, Pavia, Italy. canepamaria@libero.it
authors.forename: M C
authors.initials: MC
authors.lastname: Canepa
authors.forename: P
authors.initials: P
authors.lastname: Quaretti
authors.forename: C
authors.initials: C
authors.lastname: Perotti
authors.forename: A
authors.initials: A
authors.lastname: Vercelli
authors.forename: J
authors.initials: J
authors.lastname: Rademacher
authors.forename: A
authors.initials: A
authors.lastname: Peloso
authors.forename: L
authors.initials: L
authors.lastname: Barbieri
authors.forename: E
authors.initials: E
authors.lastname: Franchi
authors.forename: L
authors.initials: L
authors.lastname: Briani
authors.forename: A
authors.initials: A
authors.lastname: Gaspari
authors.forename: S
authors.initials: S
authors.lastname: Brugnatelli
authors.forename: P
authors.initials: P
authors.lastname: Pedrazzoli
authors.forename: P
authors.initials: P
authors.lastname: Dionigi
authors.forename: M
authors.initials: M
authors.lastname: Maestri
mesh_terms: D000071916:AC133 Antigen; D015703:Antigens, CD / Q000032:analysis*; D018952:Antigens, CD34 / Q000032:analysis; D004621:Embolization, Therapeutic; D006023:Glycoproteins / Q000032:analysis*; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization; D007937:Leukapheresis; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery* / Q000628:therapy; D008115:Liver Regeneration; D009929:Organ Size; D010455:Peptides / Q000032:analysis*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011169:Portal Vein; D036542:Tomography, Spiral Computed; D014182:Transplantation, Autologous
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D018952:Antigens, CD34; D006023:Glycoproteins; D010455:Peptides; D016179:Granulocyte Colony-Stimulating Factor