title: Autologous stem cell transplantation for expansion of remnant liver volume with extensive hepatectomy.
abstract: OBJECTIVE
  The plasticity of bone marrow stem cells has been confirmed to self-renew and transdifferentiate into hepatocytes. Thus, we performed autologous stem cell transplantation for rapid liver regeneration with extensive hepatectomy in hepatocellular cancer patients.
  
  
  METHODS
  With informed consent, patients aged 20 to 75 who needed large extensive hepatectomy due to hepatocellular carcinoma were randomly divided into three groups: control, mononuclear cells (MNCs), and CD34+ cells, based on infused cell type. After portal vein embolization (PVE), mobilized MNCs or CD34+ cells were returned to the patient via the portal vein on mobilization day without manipulation. Liver volume, liver function, clinical score and Indocyanine green R15 (ICG-R15) were compared before and after PVE.
  
  
  RESULTS
  Total bilirubin, albumin, and clinical score showed significant improvement (p < 0.05) 1 week post-infusion, with no significant difference between MNC and CD34+ cell groups. Four patients (control, 1; MNC, 1; CD34+, 2) started at over 18% ICG-R15 but can be overturned after PVE. Daily hepatic volume growth (mL/day) was 2.5 for MNC and 4.9 for CD34+ groups, resulting in significant increase over controls (1.1; p < 0.05). We found no correlation between the number of applied CD34+ cells and daily gains in left lateral lobe volume.
  
  
  CONCLUSIONS
  Improvements in liver volume, liver function, clinical score and ICG-R15 suggest that autologous stem cell transplantation is a promising method for liver regeneration.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Keun Soo
authors.initials: KS
authors.lastname: Ahn
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.forename: Kyoung Un
authors.initials: KU
authors.lastname: Park
authors.forename: Seog Ki
authors.initials: SK
authors.lastname: Min
authors.forename: Hyeon Kook
authors.initials: HK
authors.lastname: Lee
authors.forename: Kyung-Ha
authors.initials: KH
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D002454:Cell Differentiation; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome