Evaluation Of The Curative Effect In Decompensated Cirrhosis Treatment By Autologous Bone Marrow Stem Cell Transplantation Via Fibroscan

ObjectivesTo evaluate the efficacy of autologous bone marrow stem cell transplantation inthe treatment of decompensated cirrhosis via Fibroscan combining with the multipleindicator.MethodsA total of58patients with decompensated cirrhosis were divided intotransplantation group(n=27) and control group(n=31).The baseline examination including liver biopsy, Fibroscan, FIB-4and conventionalbiochemical tests were conducted before therapy. All groups underwent routine medicaltreatment. Autologous bone marrow stem cell transplantation was added in thetransplantation group.The changes in symptoms, physical signs and adverse reactions of bone marrowstem cell transplantation were observed. At2wk,4wk and8wk after therapy, liverfunction and coagulation function were tested, at12wk,24wk and48wk,Fibroscan,HA and LN were added to observe. At48wk after therapy, some patientsunderwent the liver biopsy. Then the efficacy of autologous bone marrow stem celltransplantation in the treatment of cirrhosis and the role of Fibroscan in evaluation ofthe curative effect were analyzed comprehensively. ResultsSuccessful transplantation was achieved in all the27patients without seriousadverse reactions. Each group of7patients underwent the liver biopsy, they werediagnosised of cirrhosis clearly by histopathology. One patient died in transplantationgroup and two patients died in control group, the cause of death were both uppergastrointestinal hemorrhage.At8wk after therapy, the changes in symptoms and physical signs intransplantation group were better than control group. Both of the liver function andcoagulation function of two groups had improved. ALT in transplantation group andcontrol group decreased from150.93±25.21U/L and140.22±22.82U/L at pretreatmentto86.23±19.48U/L and93.10±18.93U/L at48wk, respectively (P<0.05), thedifferences between the two groups was significant(P<0.05) at8wk,12wk and24wk.The changes of TBIL in transplantation group showed statistical difference with that incontrol group at8wk,12wk and ALB was that at8wk,12wk and48wk (P<0.05).The coagulation function in two groups were both enhanced, at8wk,12wk,24wk and48wk, the transplantation group was better than control group(P<0.05).At pretreatment,12wk,24wk and48wk after transplantation, the LSM intransplantation group were31.66±6.97kPa,31.98±7.36kPa,31.35±6.73kPa and31.78±7.35kPa, respectively, there were no significant changes(P>0.05) except48wk(P<0.05), but the LSM in control group increased gradually from32.05±9.09kPa atpretreatment to36.39±9.39kPa at48wk after therapy(P<0.05), and there was astatistical difference between the two groups at48wk after treatment. The level of HAin transplantation group decreased obviously(P<0.05) while control group not, the HAin transplantation group and control group were432.81±94.88ng/mL and485.97±100.35ng/mL at24wk(P<0.05). The LN in two groups had small change, andthere was no statistical difference between them (P>0.05). ConclusionAutologous bone marrow stem cell transplantation can improve decompensatedcirrhosis significantly, the effect is also safe and reliable in short-term. Fibroscan couldbe an important means to evaluate the curative effect in cirrhosis treatment byautologous bone marrow stem cell transplantation, but also for long-term monitoring thechange of the patient’s condition.