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Liu BaochiShanghai Public Health Clinical Center
affiliated to Fudan University
Treating patients with liver cirrhosis by BMT
Decompensated liver cirrhosis is difficult to cureliver cirrhosis with AIDS is more difficult to give effective treatmentStem cell treatment bring the hope for the patients of AIDS with decompensated liver cirrhosis.
BACKGROUND
7 AIDS patients with decompensated liver cirrhosis and portal ven hypertention , ascites, internal blooding were investigated.
Patients
Splenectomy were performed in 7 AIDS patients with liver cirrhosis to alleviate portal vein hypertention and avoid internal blooding.
Methods
During the surgical procedure, a catheter was placed in the superior mesenteric vein in preparation for bone marrow transfusion (BMT).
20mL bone marrow was aspirated by puncture of the iliac crest one week after surgery and transfused through the attached catheter into the portal vein.
Methods
Methods One or two doses of BMT were performed on each patient at a one month interval.
Results
Except diminishment of ascites and recovery of serum albumin levels, total white blood cells and platelet count was also significantly improved. Unexpectedly, one month after BMT, CD4+ T cell count in peripheral blood of all 7 patients began to increase significantly.
age before 1month 3month 12month 24month56 61 81 269 341 51236 80 120 366 519 541322741
130 265 141
244289235
411999326
6121112776
6361126
3539
303 491
864768
10871127
age before 1month 3month 12month 24month56 228 318 368 512 82536 529 621 686 648 796322741
256 324 312
362649462
4181886542
4781892968
6391896
3539
174 680
269826
14862327
changes of CD4+ T lymph cell ( /ul)
changes of CD8+ T lymph cell ( /ul)
age before 1month 3month 12month 24month56 30.8 34.1 34.6 38.6 40.136 33.5 35.6 36.8 38.8 38.9322741
27.4 36.3 31.3
38.236.828.6
37.938.634.2
38.139.638.2
38.841.1
3539
37 34.1
39.438.4
36.339.2
age before 1month 3month 12month 24month56 12.9 13.6 16 . 4 16.1 15,236 48.2 38.6 31.6 28.4 26.4322741
56.9 16.7 57.5
38.918.965.5
32.418.142.6
26.817.931.5
31.616.6
3539
21.8 19.2
19.216.4
8.514.2
changes of albumin ( g/L)
changes of Tbl ( umol/L )
age before 1month 3month 12month 24month55 2.1 6.6 5 . 4 5.1 6,236 1.89 7.6 6.6 6.4 5.4322741
2.14 2 2.54
3.98.911.4
5.47.18.6
5.86.97.6
5.66.5
3539
3.35 5.55
5.15.4
7.46.4
age before 1month 3month 12month 24month55 36 306 286 254.6 26836 26.7 296 326.4 284 246322741
101 56 28
412419177
346427286
264.6310288
289289
3539
16 133
153312
187342
changes of WBC ( ×109/L )
changes of Plate ( ×109/L)
age before 1month 3month 12month 24month55 107 109 114 126 13236 88.6 102.6 129 132 112322741
63.3 55 87
89.494.2109
121118112
131121118
134128
3539
125 60
13088
11996
age before 1month 3month 12month 24month56 17 15.2 14 14.2 13.636 19.1 14.8 13.6 14 14.1322741
17.9 18.3 22.1
1614.117.9
14.414.616.2
13.814.214.4
14.214.1
3539
19.1 17.1
14.615.8
14.314.9
changes of Hb ( g/L)
changes of PT( 秒 )
A. Rabson, Cell Death&Disease, 2013
liver cirrhosis and highly enlarged spleen with huge amout of ascites before operation
four months after operation and BMT. Ascites disappeared and liver enlarged
It may change the standard of liver transplantation
Clinical significance of BMT
BMT for the AIDS patient with liver cirrhosis can promote liver function and immune reconstruction.
Conclusion