The Effect Of Autologous Bone Marrow Stem Cell Transplantation For Decompensated Cirrhosis

Background and ObjectiveChina is one of the areas where it is a high incidence of liver disease. The number of people who are infected with HBV is only more than100million; millions of people are chronic hepatitis patients and many of them will eventually become liver cirrhosis. Liver cirrhosis is the main cause of death with liver disease. About110000people die from decompensated cirrhosis each year, so the treatment of liver cirrhosis has been constantly explored and innovated. Medical treatment can improve liver function and symptoms, but long-term effect is poor. OLT can improve liver function, life quality and prolong lives of patients with liver disease, so it is the most ideal treatment in theory. However, OLT is limited in clinic because of expensive cost, liver transplanting rejection and lacking of liver source. Artificial liver can temporarily replace liver function to assist the treatment of liver disease, but the replacement ability is limited. There is a potential risk of infection, allergic reaction and allograft rejection and it doesn’t belong to the etiological treatment, so artificial liver is not the best choice for patients with liver disease. In recent years, many scholars have been exploring a new method which is economic, feasible and no supply limiting relation.It is Autologous stem cell transplantation (ASCT) that implants bone marrow stem cells into one’s own body. ASCT can repair or replace damaged liver cell and it can reconstruct liver structure and function. This method can avoid transplanting rejection; it is a simple and cheap treatment which does not violate the medical ethics. Autologous stem cell transplantation in the treatment of liver disease has obtained certain result in China, Russia, the United States, Britain, Japan and other countries. Yannaki E collected the bone marrow stem cells with G-CSF mobilization and treated2patients with liver cirrhosis. Later he found that the formation of blood vessels were increased and CTP, MELD scores were improved. Japanese scholars extracted bone marrow from chronic hepatitis patients and separated out bone marrow stem cells and infused it back to body through the peripheral circulation. It was found that the patient’s symptoms were obviously improved, albumin and total protein level was obviously increased. Chinese scholars Yao Peng, Wang Shuai, Wang Di, Pan Xingnan and so on also did a lot of related research, and had achieved remarkable results. So autologous stem cell transplantation provides a new hope for patients with liver disease and has opened up a new direction for the treatment of liver cirrhosis.Many’scholars have made great success in the basic research of stem cell transplantation; the theoretical and experimental research are more mature. Many scholars also have carried out the clinical laboratory study. This study is carried out on its basis. We choose case in strict accordance with the indications, observe clinical symptoms/signs, monitor biochemical parameters and Child-Turcotte-Pugh (CTP) hierarchical situation after autologous stem cell transplantation.It is to understand the bone marrow mobilization effect, the quantity and quality of separated bone marrow stem cells. It is to understand the safety, feasibility and curative effect of autologous bone marrow stem cell transplantation for decompensated cirrhosis. It is to explore a new way for the treatment of liver disease and to provide the basis for clinical application widely.Materials and methods1. Recombinant human granulocyte colony stimulating factor injection (Li Sheng Su) was used for bone marrow mobilization.2. Using "Marrow&Cord Blood Stem Cells Isolating Reagents" to separate and purify bone marrow stem cells. Carry out cell counting in the microscope, the cell vitality inspection by typan blue staining and bacteriologic studies experiment.3. The surgery of superselective hepatic artery infusion of autologous bone marrow stem cells by DSA was treated patients with decompensated cirrhosis. After2w,4w and8w, the automatic chemistry analyzer (ACA) was used to monitoring biochemical parameters. The change of clinical symptoms, signs, CTP hierarchical situation in different time points and adverse reactions were observed and recorded. They are compared and analyzed before and after transplantation.Results1. The white blood cells (W-BC), neutrophilicgranulocyte (NE), lymphatic cells (LY) and mononuclear cells (MO) were increased significantly after using rhG-CSF mobilized bone marrow in the peripheral blood.2. The number of cells was3.8x108/ml～2.1×109/ml and they were separated by using cell separation kit. The cell vitality was above96%, no bacterial contamination.3. After treatment of autologous stem cell transplantation in patients with decompensated cirrhosis, the liver function, coagulant function and clinical symptoms in patients were improved obviously, no serious adverse reactions.Conclusion1. The effect of rhG-CSF mobilized bone marrow stem cell is remarkable; the adverse reaction is few and the patients are easy to accept.2. It is simple and high stem cell survival rate that "Marrow&Cord Blood Stem Cells Isolating Reagents"is used to separate and purify bone marrow stem cells. This separation technology can be widely applied.3. The treatment of the autologous stem cell transplantation in patients with decompensated cirrhosis can obviously improve liver function, blood clotting, clinical symptoms, clinical signs, and CTP hierarchical situation in different time points. The treatment method is very effective, safe and reliable, easy to operate, low prices and fewer adverse reactions.