Beta
43703

Autologous bone marrow mesenchymal stem cells transplantation in patients with liver cirrhosis

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Clinical and Chemical Pathology

Advisors

El-Anssari, Mirvat S. , Eyada, Taysir M. , Khaled, Eiman A. , Mugawer, Muhammad S.

Authors

Wahdan, Marwa Samir

Accessioned

2017-07-12 06:42:11

Available

2017-07-12 06:42:11

type

M.D. Thesis

Abstract

Orthotopic liver transplantation is the only definitive therapeutic option available for patients with chronic end-stage liver disease. However, a shortage of suitable donor organs and requirement for immunosuppression restrict its usage, highlighting the need to find suitable alternatives. Stem cell therapy has emerged as a novel approach for the treatment of many human degenerative diseases such as liver cirrhosis. MSCs are the most potent component of bone marrow cells in hepatic dif¬feren¬tiation. The aim of this study was to evaluate the effect of autologous transplantation of bone marrow derived mesenchymal stem cells in cirrhotic patients following chronic hepatitis C virus infection. Twenty-five patients with Child C liver cirrhosis, Model of End–Stage Liver Disease (MELD) score > 12 were included. They divided into 2 groups. The 1st group, the MSCs group (n = 15) included patients with cirrhotic liver infused by mesenchymal stem cells. Their ages ranged between 32 and 60 years with mean value 48.0±7.4 years. They were 11 males (73%) and 4 females (27%). This group was subdivided into two subgroups: Group Ia: who received MSCs after culture without differentiation (n = 9). Their ages ranged between 32 and 60 years with mean value 47.0±9.3 years. They were 7 males (77.8%) and 2 females (22.2%). Group Ib: who received MSCs after differentiation into hepatocytes (n = 6). Their ages ranged between 44 and 55 years with mean value 49.0±3.8 years. They were 4 males (66.7%) and 2 females (33.3%). The 2nd group, control group (n=10) involved patients with cirrhotic liver under conventional supportive treatment. Their ages ranged between 39 and 60 years with mean value 51.6±7.2 years. They were 8 males (80%) and 2 females (20%). Ninety ml bone marrow was aspirated from the iliac bone for separation of MSCs. Surface expression of CD271, CD29 and CD34 were analyzed using flowcytometry. Hepatogenesis was assessed by immunohistochemicl expression of OV6, AFP and albumin. Finally approximately 10 million MSCs/ 5ml saline were infused peripherally in one session. There was highly statistical significant difference between CD271 and CD29 before and after culture, p value was <0.01. Monthly follow up of patients for 6 months revealed partial improvement of liver function tests with elevation of prothrombin concentration and serum albumin levels, decline of elevated bilirubin and improvement in MELD score in MSCs group. There was statistically significant difference between serum bilirubin, albumin, MELD score and creatinine level before and after MSCs injection in MSCs group, p value was <0.05. Statistical comparisons between the two subgroups (group Ia) and (group Ib) did not merit any significant difference regarding clinical and laboratory findings. In conclusion MSCs are the most potent component of bone marrow cells in its ability to differentiate into hepatocytes thus, bone marrow stem cell transplantation, particularly MSC transplantation can be used as a potential treatment for liver cirrhosis. The dose, frequency and route of administration of this treatment are still to be defined.

Issued

1 Jan 2011

DOI

http://dx.doi.org/10.21473/iknito-space/37640

Details

Type

Thesis

Created At

28 Jan 2023