Decompensated Liver Cirrhosis Clinical Trial
Official title:
Safety and Efficacy of Human Unbilical Cord Derived-mesenchymal Stem Cells Treatment for Patients With Decompensated Liver Cirrhosis
Decompensated liver cirrhosis is a life-threatening chronic liver disease with high mortality. Liver transplantation is the only option that can improve the survival of these patients; however, this procedure is associated with several limitations, such as the severe shortage of donor livers, long waiting lists, multiple complications, and high cost. Our and other previous studies have demonstrated that marrow bone-derived mesenchymal stem cells (BM-MSC) or unbilical cord derived MSC (UC-MSC) infusion is clinically safe and could improve liver function in patients with decompensated liver cirrhosis. However, the long-term outcomes of MSC infusion have not been reported until now. This prospective and randomized controlled study examined the longer-term safety and efficacy of UC-MSC in patients with decompensated liver cirrhosis.
Liver cirrhosis represents a late stage of progressive hepatic fibrosis characterized by the
formation and accumulation of an extracellular matrix, which leads to the progressive
distortion of the hepatic architecture. In China, the most important cause of liver cirrhosis
is chronic hepatitis B virus (HBV) infection. Liver cirrhosis usually progresses irreversibly
into advanced stage, such as a decompensated stage which is characterized by a series of
clinical manifestations, including ascites, variceal hemorrhage, and hepatic encephalopathy
with high mortality. Liver transplantation is the only option that can improve the survival
of these decompensated liver cirrhosis patients; however, this procedure is associated with
several limitations, such as the severe shortage of donor livers, long waiting lists,
multiple complications, and high cost. Therefore, it is urgent to find a safe and effective
therapeutic approach to decompensated liver cirrhosis.
Animal models have shown that bone marrow-derived MSC (BM-MSC) can ameliorate liver fibrosis
and reverse fulminant hepatic failure. In clinical, autologous BM-MSC have significantly
improved liver function in patients with liver cirrhosis. A recent research also found that
autologous BM-MSC therapy safely improved histological fibrosis and liver function in
patients with alcoholic cirrhosis. Allogeneic MSC therapy, such as umbilical cord-derived MSC
(UC-MSC), have shown to be safe and beneficial for the patients with liver cirrhosis caused
by autoimmune diseases. Our previous studies showed that infusions of UC-MSC significantly
improved liver function in decompensated liver cirrhosis and primary biliary cirrhosis (PBC)
patients and increased the survival rate in acute-on-chronic liver failure (ACLF) patients.
However, the single-center clinical study, the relative small size of the patient cohorts,
absence of evaluation on long-term efficacy prevent firm conclusions being made with regard
to the safety and efficacy of this treatment in liver diseases.
The purpose of this study is to investigate whether and how UC-MSC can improve the liver
function, and the incidence of serious complications in patients with decompensated liver
cirrhosis through a multi-center clinical study.
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