Hepatocyte transplantation for inherited factor VII deficiency.

Abstract

Hepatocyte transplantation has been investigated in patients with liver-based metabolic disorders and acute liver failure. We report the first use of hepatocyte transplantation in two brothers with severe inherited coagulation factor VII deficiency. Patient 1 received a total of 1.09x10(9) cryopreserved hepatocytes, and patient received 2.18x10(9) fresh and cryopreserved hepatocytes through a Hickman line inserted in the inferior mesenteric vein. Infusion of isolated human hepatocytes improved the coagulation defect and markedly decreased the requirement for exogenous recombinant factor VII (rFVIIa) to approximately 20% of that before cell transplantation. In both patients, episodes of line sepsis were associated with an increase in rFVIIa requirement. Six months posthepatocyte transplantation, higher rFVIIa doses were required, suggesting loss of transplanted hepatocyte function. Because of increasing problems with venous access and long-term uncertainty of the efficacy of hepatocyte transplantation, orthotopic liver transplantation was performed successfully in both cases.

• Authors: Anil Dhawan, Ragai R Mitry, Robin D Hughes, Sharon Lehec, Claire Terry, Sanjay Bansal, Rupen Arya, Jim J Wade, Anita Verma, Nigel D Heaton, Mohamed Rela, Giorgina Mieli-Vergani
• Journal: Transplantation (Transplantation) Vol. 78 Issue 12 Pg. 1812-4 (Dec 27 2004) ISSN: 0041-1337 [Print] United States
• PMID: 15614156 (Publication Type: Case Reports, Journal Article)

Chemical References

• Recombinant Proteins
• Factor VII

Topics

• Adolescent
• Adult
• Child, Preschool
• Dose-Response Relationship, Drug
• Factor VII (administration & dosage, therapeutic use)
• Factor VII Deficiency (genetics, surgery)
• Female
• Hepatocytes (transplantation)
• Humans
• Infant
• Infusions, Intravenous
• Liver Transplantation
• Male
• Recombinant Proteins (administration & dosage, therapeutic use)
• Treatment Outcome