Safety And Efficacy Of Umbilical Cord Blood Mesenchymal Stem Cell Transplantation For Decompensated Cirrhosis

Objective:To investigate the safety and efficacy of umbilical cord blood mesenchymal stem cell transplantation for decompensated cirrhosis.Methods:A total of 87 patients with decompensated cirrhosis after viral hepatitis B were collected,Among them,37 patients voluntarily chose umbilical cord blood mesenchymal stem cell transplantation treatment as the experimental group(30 males and 7 females,with an average age of 48.95±8.73 years),while the remaining 50 patients chose general medical treatment as the control group(31 males and 19 females).At 1,6 and 12 months after treatment,follow-up questionnaire after treatment in both groups general condition improved after treatment in patients with life quality score evaluation,review collected patients serum transaminase and serum total bilirubin,serum albumin,clotting function,ascites,laboratory indexes to assess liver function,and through the Child-Pugh score,cirrhosis model score,indocyanine green 15 minutes retention rates(ICG-R15)assess progress improvement to cirrhosis of the liver.Results:(1)The general postoperative conditions of the patients in the experimental group can be improved at 6 and 12 months after surgery,including appetite,spirit,sleep,pain,jaundice,ascites,etc.,and the quality of life score can be effectively improved,better than the control group,with statistically significant difference(P<0.05).(2)Experimental group postoperative liver function index of serum total bilirubin TBIL(umol/L),albumin propagated(g/L),prothrombin time PT(s)of the liver enzyme indicators,aspartate amino transferase AST(U/L)and alanine aminotransferase ALT(U/L),ascites depth(cm)and Child-Pugh score were obviously improved at each time node of follow-up,and the differences were statistically significant(P < 0.05),the control group after treatment serum total bilirubin TBIL(umol/L),aspartate aminotransferase AST(U/L)and alanine aminotransferase ALT(U/L),prothrombin time(in seconds),and the Child-Pugh score before treatment has no obvious difference(P >0.05),but the ascites depth(cm),albumin(g/L)have improved in the early stage of treatment,with statistically significant differences.the difference was statistically significant(P< 0.05),However,the treatment effect fluctuated,and decreased to the same level as that before treatment at 12 months ’follow-up after treatment(P>0.05).,And,compared with the control group,the experimental group had better effect on the improvement of ascites depth(cm)and albumin ALB(g/L),and the treatment effect is more stable,and the difference was statistically significant(P<0.05).(3)After transplantation,ICG-R15 and fib-4 score of cirrhosis model in the experimental group were significantly improved in each follow-up period compared with that before transplantation,with statistically significant difference(P<0.05),while no statistically significant difference was found in the control group during the follow-up period(P>0.05).(4)In this study,no acute adverse reactions(hemolysis,acute rejection,sepsis,intra-abdominal bleeding,bile leakage,etc.)occurred in 37 patients of the experimental group from the time of transplantation to the time of discharge 7 days after surgery.Up to 1 month after the operation,there were no complications such as infection in the operative area,chronic rejection reaction and other adverse reactions,and no symptoms related to portal hypertension such as gastrointestinal bleeding,hypersplenism,and coagulation disorder.Up to 12 months after the operation,the patients in the experimental group had no complicated hepatic encephalopathy,no long-term complications such as massive gastrointestinal bleeding,and no long-term complications such as death due to transplant-related factors during the follow-up period.Conclusion:(1)Umbilical cord blood mesenchymal stem cell transplantation is a safe and feasible treatment for decompensated cirrhosis.(2)Umbilical cord blood mesenchymal stem cell transplantation can effectively improve liver function in patients with decompensated cirrhosis,reduce serum transaminase level,improve blood clotting function,increase serum albumin level,reduce abdominal fluid volume,reduce Child score of liver function,and delay and reverse the progression of cirrhosis.At the same time,the quality of life score of patients after transplantation was significantly improved compared with that before surgery.