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First example of hepatocyte transplantation to alleviate ornithine transcarbamylase deficiency, monitored by NMR-based metabonomics.

Abstract
We demonstrate the effective use of NMR spectroscopic profiles of urine and plasma from the first successful use of hepatocyte transplantation as a bridge to auxiliary partial orthotopic liver transplantation in a child antenatally diagnosed with severe ornithine transcarbamylase deficiency. In this single-patient study, NMR profiles indicated that the disrupted urea cycle could be normalized by hepatocyte cell infusion and this was confirmed using orthogonal partial least-squares-based chemometrics. However, despite dietary manipulations and adminstration of ammonia scavengers, the desired reduction in plasma ammonia was not consistently achieved between sessions of hepatocyte transplantation due to episodes of sepsis. A subsequent liver transplant corrected the metabolic abnormalities. The use of metabolic profiling has been shown to be a promising method for evaluating the efficacy of cell infusions and has demonstrated the capability for the early detection of response to therapy in real time, an approach that may be of use in wider clinical settings.
AuthorsCristina Legido-Quigley, Olivier Cloarec, David A Parker, Gerard M Murphy, Elaine Holmes, John C Lindon, Jeremy K Nicholson, Ragai R Mitry, Hector Vilca-Melendez, Mohamed Rela, Anil Dhawan, Nigel Heaton
JournalBioanalysis (Bioanalysis) Vol. 1 Issue 9 Pg. 1527-35 (Dec 2009) ISSN: 1757-6199 [Electronic] England
PMID21083101 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Ammonia
  • Urea
Topics
  • Ammonia (blood, urine)
  • Hepatocytes (physiology, transplantation)
  • Humans
  • Infant
  • Infant, Newborn
  • Liver Transplantation
  • Magnetic Resonance Spectroscopy
  • Male
  • Metabolomics (methods)
  • Monitoring, Physiologic (methods)
  • Mutation
  • Ornithine Carbamoyltransferase Deficiency Disease (blood, surgery, urine)
  • Sepsis (blood, diagnosis, urine)
  • Treatment Outcome
  • Urea (blood, urine)

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