A novel stem cell therapy for hepatitis B virus-related acute-on-chronic liver failure

• Autor(a) principal: Zhu,Bing
• Data de Publicação: 2020
• Outros Autores: You,Shaoli, Rong,Yihui, Yu,Qiang, Lv,Sa, Song,Fangjiao, Liu,Hongling, Wang,Huaming, Zhao,Jun, Li,Dongze, Liu,Wanshu, Xin,Shaojie
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Medical and Biological Research
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2020001100613
• topic: Stem cell transplantation; Hepatic artery transfusion; Acute-on-chronic liver failure; Hepatitis B virus; Randomized controlled trial

The aim of this study was to propose a stem cell therapy for hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) based on plasma exchange (PE) for peripheral blood stem cell (PBSC) collection and examine its safety and efficacy. Sixty patients (n=20 in each group) were randomized to PE (PE alone), granulocyte colony-stimulating factor (G-CSF) (PE after G-CSF treatment), and PBSC transplantation (PBSCT) (G-CSF, PE, PBSC collection and hepatic artery injection) groups. Patients were followed-up for 24 weeks. Liver function and adverse events were recorded. Survival analysis was performed. PBSCT improved blood ammonia levels at 1 week (P<0.05). The level of total bilirubin, international normalized ratio, and creatinine showed significant differences in the 4th week of treatment (P<0.05). The survival rates of the PE, G-CSF, and PBSCT groups were 50, 65, and 85% at 90 days (P=0.034). There was a significant difference in 90-day survival between the PE and PBSCT groups (P=0.021). The preliminary results suggested that PBSCT was safe, with a possibility of improved 90-day survival in patients with HBV-ACLF.