Liver Cirrhosis Clinical Trial
Official title:
Adult Stem Therapy for Patients With Liver Insufficiency
In order to determine the clinical application potential of adult stem cells we propose to
investigate the safety and toxicity of infusing adult stem cells in the hepatic artery or
portal vein of five patients with chronic liver insufficiency and to identify any clinical
benefit if such occurs.
Objectives:
1. To assess safety and treatment related toxicities
2. To determine clinical benefit or deterioration by monitoring changes in liver function
The liver in an adult healthy body maintains a balance between cell gain and cell loss.
Though normally proliferatively quiescent, hepatocyte loss such as that caused by partial
hepatectomy, uncomplicated by virus infection or inflammation, invokes a rapid regenerative
response to restore liver mass. This restoration of moderate cell loss and 'wear and tear'
renewal is largely achieved by hepatocyte self-replication. More severe liver injury can
activate a potential stem cell compartment located within the intrahepatic biliary tree,
giving rise to cords of bipotential, so-called, oval cells within the lobules that can
differentiate into hepatocytes and biliary epithelial cells. A third population of stem cells
with hepatic potential reside in the bone marrow; these haematopoietic stem cells can
contribute to the albeit low renewal rate of hepatocytes, make a more significant
contribution to regeneration and even completely restore normal function in a murine model of
hereditary tyrosinaemia.
A recent abstract has suggested that an astonishingly high number of bone marrow cells (~25%
of liver parenchyma occupied by bone marrow-derived cells) will engraft and differentiate
into hepatocytes in a model of cirrhosis in the mouse when injected intravenously. More
importantly, this bone marrow infusion resulted in significant improvements in liver function
(serum albumin) within the cirrhotic animals.
This is a safety and toxicity study in five patients with chronic liver disease. Each will
receive autologous stem cells 10 to the sixth cells via the hepatic artery or portal vein
under image guided scanning. Patients will be followed for a total of 60 days.
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