血浆置换和脐带间充质干细胞移植治疗乙型肝炎病毒相关急

StephenW

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Stem Cells Int. 2019 Feb 4;2019:4130757. doi: 10.1155/2019/4130757. eCollection 2019.
Combination Treatments of Plasma Exchange and Umbilical Cord-Derived Mesenchymal Stem Cell Transplantation for Patients with Hepatitis B Virus-Related Acute-on-Chronic Liver Failure: A Clinical Trial in China.
Xu WX#1,2, He HL#3, Pan SW2,4, Chen YL1,2, Zhang ML1,2, Zhu S1,2, Gao ZL1,2, Peng L1,2, Li JG1,2.
Author information

1
    Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, China.
2
    Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, China.
3
    Department of Infectious Diseases, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui, China.
4
    Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, China.
#
    Contributed equally

Abstract
Background:

Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a common type of liver failure with a high mortality. This study aimed at investigating the safety and efficacy of the combination treatment of plasma exchange (PE) and umbilical cord-derived mesenchymal stem cell (UC-MSCs) transplantation for HBV-ACLF patients.
Methods:

A total of 110 HBV-ACLF patients treated in our hospital from January 2012 to September 2017 were enrolled into this trial and divided into the control group (n = 30), UC-MSC group (n = 30), PE group (n = 30), and UC-MSC + PE group (n = 20) based on their treatments. The hepatic function, coagulation, and virological and immunological markers were assessed at baseline and 30, 60, 90, 180, and 360 days. The endpoint outcomes were death and unfavorable outcome (need for liver transplantation or death).
Results:

The UC-MSC + PE group had the lowest rates of death and unfavorable outcome at 30 days, 60 days, and 90 days posttreatment among the four groups, but the difference did not reach significances. The multivariate logistic regression analysis demonstrated that hemoglobin, prothrombin activity, and MELD (model for end-stage liver disease) score were the independent factors associated with the unfavorable outcome (all P < 0.05). The levels of total bilirubin, alanine aminotransferase, aspartate transaminase, and MELD score were significantly decreased during treatments (all P < 0.05).
Conclusion:

UC-MSCs combined with PE treatment had good safety but cannot significantly improve the short-term prognosis of HBV-ACLF patients with as compared with the single treatment. The long-term efficacy should be further evaluated. This trial is registered with registration no. NCT01724398.

PMID:
    30863450
PMCID:
    PMC6378797
DOI:
    10.1155/2019/4130757

StephenW

干细胞Int。 2019年2月4日; 2019年：4130757。 doi：10.1155 / 2019/4130757。 eCollection 2019。
血浆置换和脐带间充质干细胞移植治疗乙型肝炎病毒相关急性慢性肝功能衰竭的综合治疗：中国临床试验。
Xu WX＃1,2，He HL＃3，Pan SW2,4，Chen YL1,2，Zhang ML1,2，Zhu S1,2，Gao ZL1,2，Peng L1,2，Li JG1,2。
作者信息

1
    中山大学附属第三医院感染科，广东广州510630
2
    中山大学附属第三医院广东省肝病研究重点实验室，广东广州510630
3
    中国科学技术大学生命科学与医学系，中国科学技术大学第一附属医院感染科，安徽合肥230001
4
    中山大学附属第三医院检验科，广东广州510630
＃
    贡献一致

抽象
背景：

乙型肝炎病毒相关的急性慢性肝功能衰竭（HBV-ACLF）是一种常见的肝衰竭类型，死亡率很高。本研究旨在探讨血浆置换（PE）和脐带间充质干细胞（UC-MSCs）联合治疗HBV-ACLF患者的安全性和有效性。
方法：

2012年1月至2017年9月我院收治的110例HBV-ACLF患者入选本组，分为对照组（n = 30），UC-MSC组（n = 30），PE组（n = 30） 30）和UC-MSC + PE组（n = 20）基于他们的治疗。在基线和30,60,90,180和360天评估肝功能，凝血和病毒学和免疫学标志物。终点结果是死亡和不利结果（需要肝移植或死亡）。
结果：

UC-MSC + PE组在治疗后30天，60天和90天的死亡率和不良结果率最低，但差异无显着性。多因素logistic回归分析显示，血红蛋白，凝血酶原活性和MELD（终末期肝病模型）评分是与不良结果相关的独立因素（均P <0.05）。治疗期间总胆红素，丙氨酸氨基转移酶，天冬氨酸转氨酶和MELD评分均显着下降（均P <0.05）。
结论：

UC-MSCs联合PE治疗具有良好的安全性，但与单一治疗相比，不能显着改善HBV-ACLF患者的短期预后。应进一步评估长期疗效。该试验注册时注册号为。 NCT01724398。

结论：
    30863450
PMCID：
    PMC6378797
DOI：
    10.1155 /四百十三万零七百五十七分之二千零一十九

StephenW

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