Long-term outcome of autologous hematopoietic stem cell infusion in cirrhosis: Waning effect over time

Abstract

Background and Aims: Long-term data on cell-based therapies, including hematopoietic stem cell infusion in cir-rhosis, are sparse and lacking. Methods: Patients with cirrhosis of non-viral etiology received either standard-of-care (n = 23) or autologous CD34+ cell infusion through the hepatic artery (n = 22). Study patients received granulocyte col-ony-stimulating factor (commonly known as G-CSF) injections at 520 mgm per day for 3 days, followed by leuka-pheresis and CD34+ cell infusion into the hepatic artery. The Control group received standard-of-care treatment. Results: Mean CD34+ cell count on the third day of G-CSF injection was 27.00 ± 20.43 cells/mL 81.84 ± 11.99 viability and purity of 80-90%. Significant improvement in the model of endstage liver disease (commonly known as MELD) score (15.75 ± 5.13 vs. 19.94 ± 6.68, p = 0.04) was noted at end of 3 months and 1 year (15.5 ± 5.3 vs. 19.8 ± 6.4, p = 0.04) but was not statistically different at end of the second (17.2 ± 5.5 vs. 20.3 ± 6.8, p = 0.17) and third-year (18.4 ± 6.1 vs. 21.3 ± 6.4, p = 0.25). No difference in mortality (6/23 vs. 5/23) was noted. Conclusions: Autologous CD34+ cell infusion effectively improved liver function and MELD score up to 1 year but the sustained benefit was not maintained at the end of 3 years, possibly due to ongoing progression of the underlying disease. Citation of this article: Sharma M, Kulkarni A, Sasikala M, Kumar P, Jaggaiahgari S, Pondugala K, et al. Long-term outcome of autologous hematopoietic stem cell infusion in cir-rhosis: Waning effect over time. J Clin Transl Hepatol 2020;8(4):385–390. doi: 10.14218/JCTH.2020.00052.