The only presently viable treatment for
end-stage liver disease is whole
organ transplantation. However, there are insufficient livers available. The aim of the present study is to provide autologous bone marrow-derived stem cells as a potential therapeutic for patients with end-stage
cirrhosis. This is a retrospective chart review of autologous stem cell treatment in 48 patients, 36 with chronic end-stage
hepatitis C-induced
liver disease and 12 with end-stage autoimmune
liver disease. For all patients,
granulocyte colony-stimulating factor was administered to mobilize their hematopoietic stem cells. Following leukapheresis, CD34(+) stem cells were isolated, amplified, and partially differentiated in culture, then reinjected into each subject via their hepatic artery or portal vein. Treatment was generally well tolerated with the expected moderate but transient bone
pain from
G-CSF in less than half of the patients. Three patients had serious treatment-related complications, and only 20.8% of these
end-stage liver disease patients died during 12 months of follow up. For all patients there was a statistically significant decrease in
ascites. There was clinical and biochemical improvement in a large percentage of patients who received the
transplantation. In the viral group, there were marked changes in
albumin (p = 0.0003),
bilirubin (p = 0.04), INR (p = 0.0003), and ALT levels (p = 0.02). In the autoimmune group, values also improved significantly for
albumin (p = 0.001),
bilirubin (p = 0.002), INR (p = .0005), and ALT levels (p = 0.003). These results suggest that autologous CD34(+)
stem cell transplantation may be safely administered and appears to offer some therapeutic benefit to patients with both viral and autoimmune-induced
end-stage liver disease.