A case report on intraportal injection of autologous bone marrow-derived mononuclear cells and liver transplantation in a patient with cirrhosis

To date, liver transplantation remains the only effective treatment for patients with cirrhosis. Due to lack of other effective, alternative therapeutic methods, the search and development of new treatment technologies is problem number one. The development of cellular technologies is promising for use in clinical practice. Using this observation as an example, the safety and efficacy of cell therapy technology for prolonged stay on the liver transplant waiting list by a patient with cirrhosis is shown. After intraportal injection of autologous bone marrow-derived mononuclear cells, liver cirrhosis stabilized on the CTP and MELD-Na scales for 22 months of observation, which allowed the patient to wait for an organ and successfully undergo liver transplantation.

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Intraportal therapy of autologous bone marrow mononuclear cells in patients on the waiting list for liver transplantation

Medical academic journal ◽

10.17816/maj18332-40 ◽

2018 ◽

Vol 18 (3) ◽

pp. 32-40

Author(s):

D A Granov ◽

A R Sheraliev ◽

O A Gerasimova ◽

A A Polikarpov

Keyword(s):

Bone Marrow ◽

Liver Transplantation ◽

Portal Vein ◽

Mononuclear Cells ◽

Autologous Bone Marrow ◽

Meld Score ◽

Waiting List ◽

Bone Marrow Mononuclear Cells ◽

Autologous Bone ◽

Intraportal Infusion

This study was carried out to explore the methodology of intraportal infusion of autologous bone marrow mononuclear cells in patients in the waiting list for liver transplantation. The study included eight patients. The Model for End-Stage Liver Disease (MELD) score as a predictor of hepatic failure exceeds 10 points, i.e., 12-22 points. According to Child-Turcotte-Pugh (CTP) classification, the severity of cirrhosis ranged from class B to C. The bone marrow volume of 224-320 ml was harvested by bilateral aspiration from the posterior iliac crest. The total volume of the mononuclear cells (MNC) was 47.1-58.3 ml (median, 47 ml). The absolute viable count of isolated MNC was 1.24 · 109-5.84 · 109 and CD34+ cells 2.54 · 106-48.20 · 106. After portal vein catheterization, direct transhepatic portography was performed, and portosystemic collaterals were found in all cases. Portal flowmetry was performed to determine the optimal selective perfusion rate of the segmental branches of the portal vein. Portal vein infusion was performed at 0.3-1.5 ml/sec. Serious side effects were not detected during bone marrow harvesting and MNC infusion. All patients had stable condition (no deterioration was initially noticed) after MNC infusion according to the MELD score and CTP criteria during a 3-month observation. Moreover, improvement in physical health status was observed and obtained using the SF-36 questionnaire. This study confirmed the safety of using intraportal therapy of autologous bone marrow MNC in patients on the waiting list for liver transplantation. Herein, we presented the technique of target delivery of autologous bone marrow MNC to the liver to minimize their loss during intraportal infusion. Prolonged follow-up time and improvement of the present technique are needed for further evaluation of the efficiency of autologous bone marrow MNC.

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Treatment of Adult Severe Traumatic Brain Injury Using Autologous Bone Marrow Mononuclear Cells

10.21236/ada570264 ◽

2012 ◽

Cited By ~ 1

Author(s):

Charles Cox

Keyword(s):

Traumatic Brain Injury ◽

Bone Marrow ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Mononuclear Cells ◽

Autologous Bone Marrow ◽

Bone Marrow Mononuclear Cells ◽

Autologous Bone

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Autologous Bone Marrow-Derived Mononuclear Cells Combined With β-TCP for Maxillary Bone Augmentation in Implantation Procedures

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000000326 ◽

2017 ◽

Vol 28 (8) ◽

pp. 1982-1987 ◽

Cited By ~ 1

Author(s):

Dmitry Bulgin ◽

Enes Hodzic

Keyword(s):

Bone Marrow ◽

Mononuclear Cells ◽

Autologous Bone Marrow ◽

Bone Augmentation ◽

Maxillary Bone ◽

Autologous Bone

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Administration of Autologous Bone Marrow-Derived Mononuclear Cells in Children with Incurable Neurological Disorders and Injury is Safe and Improves their Quality of Life

Cell Transplantation ◽

10.3727/096368912x633798 ◽

2012 ◽

Vol 21 (1_suppl) ◽

pp. 79-90 ◽

Cited By ~ 37

Author(s):

Alok Sharma ◽

Nandini Gokulchandran ◽

Guneet Chopra ◽

Pooja Kulkarni ◽

Mamta Lohia ◽

...

Keyword(s):

Quality Of Life ◽

Bone Marrow ◽

Neurological Disorders ◽

Mononuclear Cells ◽

Autologous Bone Marrow ◽

Autologous Bone

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Low-risk intensive therapy for multiple myeloma with combined autologous bone marrow and blood stem cell support

Blood ◽

10.1182/blood.v80.7.1666.bloodjournal8071666 ◽

1992 ◽

Vol 80 (7) ◽

pp. 1666-1672

Author(s):

S Jagannath ◽

DH Vesole ◽

L Glenn ◽

J Crowley ◽

B Barlogie

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Mononuclear Cells ◽

Intensive Therapy ◽

Autologous Bone Marrow ◽

Blood Stem Cell ◽

High Dose ◽

Platelet Recovery ◽

Gm Csf ◽

Autologous Bone

To improve the safety of autotransplantation for myeloma, peripheral blood stem cell (PBSC) collection was attempted in 75 previously treated patients after the administration of high-dose cyclophosphamide (HD-CTX; 6 g/m2) with or without granulocyte-macrophage colony- stimulating factor (GM-CSF). Sixty patients subsequently received melphalan 200 mg/m2 (57 patients) or melphalan 140 mg/m2 and total body irradiation (850 cGy) (3 patients) supported by both autologous bone marrow and PBSC; 38 patients received GM-CSF posttransplantation. Among 72 patients undergoing PBSC apheresis, “good” mobilization (greater than 50 colony-forming units granulocyte-macrophage [CFU-GM] per 10(5) mononuclear cells) was achieved when prior chemotherapy did not exceed 1 year and when GM-CSF was used post-HD-CTX; similarly, rapid platelet recovery to 50,000/microL within 2 weeks was associated with “good” PBSC mobilization. These same variables also predicted for rapid engraftment after autotransplantation, so that hematologic recovery (granulocytes greater than 500/microL and platelets greater than 50,000/microL) proceeded within 2 weeks among the 37 patients with “good” PBSC collection. As a result of rapid neutrophil recovery (greater than 500/microL) within a median of 2 weeks, infectious complications both post-HD-CTX and posttransplant were readily manageable, resulting in only one treatment-related death post-HD-CTX. The cumulative response rate (greater than or equal to 75% cytoreduction) for all 75 patients was 68%, with 12-month event-free and overall survival projections of about 85%. Using both bone marrow and PBSC together with GM-CSF, autotransplants are safe and appear effective in myeloma, especially when prior therapy had been limited to less than 1 year. More than 80% of transplanted patients achieved complete hematologic recovery within a median of 1 month posttransplant (granulocytes greater than 1,500/microL; platelets greater than 100,000/microL; hemoglobin greater than 10 g%), thus providing sufficient hematopoietic reserve for further chemotherapy in the event of posttransplant relapse.

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