1
|
Sharma M, Kulkarni A, Sasikala M, Kumar P, Jaggaiahgari S, Pondugala K, Jaishetwar G, Darisetty S, Jagtap N, Gupta R, Singh JR, Fatima S, Rao PN, Rao GV, Reddy DN. Long-term Outcome of Autologous Hematopoietic Stem Cell Infusion in Cirrhosis: Waning Effect over Time. J Clin Transl Hepatol 2020; 8:385-390. [PMID: 33447521 PMCID: PMC7782109 DOI: 10.14218/jcth.2020.00052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/02/2020] [Accepted: 09/27/2020] [Indexed: 12/11/2022] Open
Abstract
Background and Aims: Long-term data on cell-based therapies, including hematopoietic stem cell infusion in cirrhosis, are sparse and lacking. Methods: Patients with cirrhosis of non-viral etiology received either standard-of-care (n = 23) or autologous CD34+ cell infusion through the hepatic artery (n = 22). Study patients received granulocyte colony-stimulating factor (commonly known as G-CSF) injections at 520 µgm per day for 3 days, followed by leukapheresis and CD34+ cell infusion into the hepatic artery. The Control group received standard-of-care treatment. Results: Mean CD34+ cell count on the third day of G-CSF injection was 27.00 ± 20.43 cells/µL 81.84 ± 11.99 viability and purity of 80-90%. Significant improvement in the model of end-stage liver disease (commonly known as MELD) score (15.75 ± 5.13 vs. 19.94 ± 6.68, p = 0.04) was noted at end of 3 months and 1 year (15.5 ± 5.3 vs. 19.8 ± 6.4, p = 0.04) but was not statistically different at end of the second (17.2 ± 5.5 vs. 20.3 ± 6.8, p = 0.17) and third-year (18.4 ± 6.1 vs. 21.3 ± 6.4, p = 0.25). No difference in mortality (6/23 vs. 5/23) was noted. Conclusions: Autologous CD34+ cell infusion effectively improved liver function and MELD score up to 1 year but the sustained benefit was not maintained at the end of 3 years, possibly due to ongoing progression of the underlying disease.
Collapse
Affiliation(s)
- Mithun Sharma
- Asian Institute of Gastroenterology, Hyderabad, India
- Correspondence to: Dr. Mithun Sharma, Hepatology, and Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, India. Tel: +91-4042342234, Fax: +91-4042342334, E-mail:
| | | | | | - Pramod Kumar
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | | | | | | | - Nitin Jagtap
- Asian Institute of Gastroenterology, Hyderabad, India
| | - Rajesh Gupta
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | - Syeda Fatima
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | | | | |
Collapse
|