title: Monitoring of intrasplenic hepatocyte transplantation for acute-on-chronic liver failure: a prospective five-year follow-up study.
abstract: BACKGROUND
  Acute-on-chronic liver failure (ACLF) is defined as an acute deterioration of chronic liver disease. Intrasplenic hepatocyte transplantation is increasingly recognized as a treatment for liver failure and genetic metabolic liver diseases. We describe our experience of intrasplenic hepatocyte transplantation in a small cohort of patients as bridge therapy or as an alternative to orthotopic liver transplantation (OLT).
  
  
  METHODS
  Seven patients with ACLF with an expected survival of less than 8 weeks were enrolled into the study. The donor hepatocytes were collected from 2 healthy males and cryopreserved. Donor hepatocytes were transplanted into the spleen of recipients via catheterization of the femoral artery. All patients were followed up for 5 years or to death.
  
  
  RESULTS
  A total of (4.2-6.0) × 10(10) hepatocytes were harvested from the 2 donors' livers and their survival after recovery from the frozen stock was 63% ± 2.8% and 73.5% ± 3.2%, respectively. Following intrasplenic hepatocyte transplantation, 3 patients fully recovered from liver failure, 1 survived and subsequently underwent OLT, and the remaining 3 patients died between 2.5 and 12 months after intrasplenic hepatocyte transplantation. At month 48 post-intrasplenic hepatocyte transplantation, living hepatocyte signals were observed in the spleen using magnetic resonance imaging (MRI) with gadobenate dimeglumine (Gd-BOPTA).
  
  
  CONCLUSIONS
  Intrasplenic hepatocyte transplantation is a promising therapy for liver failure that may reduce mortality rates among patients with end-stage liver disease awaiting OLT. Conceivably, intrasplenic hepatocyte transplantation may be considered an alternative to OLT for patients with acute liver failure. MRI (Gd-BOPTA) is a useful tool for detecting living hepatocytes in the spleen after intrasplenic hepatocyte transplantation.
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China.
authors: F
authors: F
authors: Wang
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China.
authors: L
authors: L
authors: Zhou
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China.
authors: X
authors: X
authors: Ma
authors: Department of Radiology, Beijing the 302(nd) Hospital, Beijing, China.
authors: W
authors: W
authors: Ma
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China.
authors: C
authors: C
authors: Wang
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China.
authors: Y
authors: Y
authors: Lu
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China.
authors: Y
authors: Y
authors: Chen
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China.
authors: L
authors: L
authors: An
authors: Department of Magnetic Resonance Imaging (MRI), Beijing the 302(nd) Hospital, Beijing, China.
authors: W
authors: W
authors: An
authors: Center of Therapeutic Research for Hepatocellular Carcinoma, Beijing the 302(nd) Hospital, Beijing, China. Electronic address: yongpingyang@hotmail.com.
authors: Y
authors: Y
authors: Yang
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000401:mortality / Q000628:therapy*; D000328:Adult; D049109:Cell Proliferation; D003287:Contrast Media / Q000737:chemistry; D015925:Cryopreservation; D005260:Female; D005263:Femoral Artery / Q000473:pathology; D005500:Follow-Up Studies; D022781:Hepatocytes / Q000166:cytology / Q000637:transplantation*; D006801:Humans; D008099:Liver / Q000601:surgery; D008107:Liver Diseases / Q000628:therapy*; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives / Q000737:chemistry; D008875:Middle Aged; D009942:Organometallic Compounds / Q000737:chemistry; D011446:Prospective Studies; D013154:Spleen / Q000473:pathology; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine