Patients suffering from advanced liver cancer have been able to grow new livers using a revolutionary stem cell technique.
Two years after the pioneering surgery, six out of the eight patients are still alive and cancerfree, with fully-functioning livers.
The technology, developed by scientists in Germany, could result in the lives of hundreds of liver cancer patients being saved.
The liver is capable of regenerating and compensating for parts that have become diseased, but at least 60 per cent of the liver must be healthy for a patient to survive while the liver regenerates.
Unfortunately, liver cancer can be difficult to detect and patients frequently have advanced disease when diagnosed.
Radiotherapy is not very effective in liver cancer and chemotherapy is often used to try to slow the spread of advanced disease. There are around 4,000 new cases of liver cancer each year and 1,700 deaths.
The new approach uses bone stem cells taken from the patient's hip.
Research has shown that this type of stem cell is capable of turning into liver cells.
Surgeons at the University of Dusseldorf took stem cells from the hips of cancer patients and injected these into the healthy, non-cancerous part of the liver in the hope that it would grow, eventually allowing the diseased part to be removed.
All the patients in the trial had just 20 per cent of healthy liver left, so it was not possible to remove the diseased part without an alternative.
Using heat, the surgeons blocked the blood supply to the diseased part of the liver and diverted the blood to the remaining healthy part. This had the effect of speeding up the growth of new liver cells.
At the same time, they took stem cells from the patient's hip and injected them into the same blood supply.
Five weeks after the stem cell transplantation, most patients' livers had more than doubled in size. This allowed surgeons to remove the part of the liver containing the tumour.
Jan Schulte Am Esch, the surgeon in charge of the trial, said the results were better than expected.
"We knew that we could take stem cells from the hip and that they would turn into liver cells because we had done this in the laboratory, but we were not sure whether the cells would take when we came to do the same in a patient.
"These were patients with advanced liver disease for whom there was no real hope. We were involved in a race against time to ensure that the tumour didn't spread to the good part of the liver or else we would not be able to help them."
Professor Gunther Furst, who helped lead the trial, says the team were amazed at how quickly the liver regenerated when it was given an infusion of stem cells.
"What we have shown is that there is an alternative to transplantation of the liver. We've also demonstrated that in the short term you save the life of a terminally ill cancer patient for whom previously there was no hope."
Specialists are now assessing whether the technique could be used to help repair the diseased livers of alcoholics or people struck down by fatty liver disease (a condition caused by obesity).
Mr Schulte Am Esch is planning to carry out largerscale trials. "We hope that in the not too distant future this will become a standard way of helping patients re-grow their livers," he says.
Professor Nagy Habib, a liver consultant at London's Hammersmith Hospital, has also been researching the use of bone marrow stem cells.
He says: "It is excellent work. Bone marrow-derived cells have the ability to get the liver to regrow. We are conducting the same work at the Hammersmith."
发表于 2007-3-29 00:52
