Rationale and prospects of mesenchymal stem cell therapy for liver transplantation.
OBJECTIVE
Despite their potential to supplement the donor organ pool, expanded donor criteria grafts are associated with an elevated risk of graft failure and increased early mortality. Likewise, attempts to promote operational graft tolerance through conventional immunosuppressive therapy have demonstrated significant safety-related drawbacks. Because of their potent regenerative and immunomodulative potential, adjunct mesenchymal stem cell (MSC) therapy represents an innovative approach to both of these clinical problems.


RESULTS
Recent studies have begun to delineate the benefit and mechanisms of short-term therapy combining MSCs and low-dose immunosuppressive drugs in promoting graft acceptance and potentially regeneration.


CONCLUSIONS
The current review presents our rationale for the first-in-man clinical trial in liver transplantation utilizing a mesenchymal cell product (MultiStem, Athersys, Cleveland, Ohio, USA). The long-term objective of this program is to safely minimize the dose of complementary immunosuppressive drugs while achieving long-term allograft survival and operational tolerance. The use of adjunct cellular therapy as a means of reducing long-term pharmacotherapy would represent a major advancement in the field of liver transplantation.
aDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA bDepartment of Surgery, University Hospital Regensburg, Regensburg, Germany.
Nataša
N
Obermajer
Felix C
FC
Popp
Christian L
CL
Johnson
Volker
V
Benseler
Marc H
MH
Dahlke
D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016031:Liver Transplantation / Q000379:methods*; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D059630:Mesenchymal Stem Cells / Q000166:cytology*; D023001:Transplantation Tolerance
D007166:Immunosuppressive Agents