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 24month

56 61 81 269 341 512

36 80 120 366 519 541

322741

130 265 141

244289235

411999326

6121112776

6361126

3539

303 491

864768

10871127

age before 1month 3month 12month 24month

56 228 318 368 512 825

36 529 621 686 648 796

322741

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 24month

56 30.8 34.1 34.6 38.6 40.1

36 33.5 35.6 36.8 38.8 38.9

322741

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 24month

56 12.9 13.6 16 ． 4 16.1 15,2

36 48.2 38.6 31.6 28.4 26.4

322741

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 24month

55 107 109 114 126 132

36 88.6 102.6 129 132 112

322741

63.3 55 87

89.494.2109

121118112

131121118

134128

3539

125 60

13088

11996

age before 1month 3month 12month 24month

56 17 15.2 14 14.2 13.6

36 19.1 14.8 13.6 14 14.1

322741

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

It may change the standard of liver transplantation

Clinical significance of BMTClinical significance of BMT

BMT for the AIDS patient with liver cirrhosis can promote liver function and immune reconstruction.

Conclusion