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
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...
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Wiley
2019-01-01
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| Series: | Stem Cells International |
| Online Access: | http://dx.doi.org/10.1155/2019/4130757 |
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| author | Wen-xiong Xu Hong-liang He Shun-wen Pan Yuan-li Chen Mei-ling Zhang Shu Zhu Zhi-liang Gao Liang Peng Jian-guo Li |
| author_facet | Wen-xiong Xu Hong-liang He Shun-wen Pan Yuan-li Chen Mei-ling Zhang Shu Zhu Zhi-liang Gao Liang Peng Jian-guo Li |
| author_sort | Wen-xiong Xu |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-5f37044285cf4274b0be25de77272c52 |
| institution | Kabale University |
| issn | 1687-966X 1687-9678 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stem Cells International |
| spelling | doaj-art-5f37044285cf4274b0be25de77272c522025-02-03T06:11:21ZengWileyStem Cells International1687-966X1687-96782019-01-01201910.1155/2019/41307574130757Combination 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 ChinaWen-xiong Xu0Hong-liang He1Shun-wen Pan2Yuan-li Chen3Mei-ling Zhang4Shu Zhu5Zhi-liang Gao6Liang Peng7Jian-guo Li8Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaDepartment of Infectious Diseases, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui, ChinaGuangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaDepartment of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaDepartment of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaDepartment of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaDepartment of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaDepartment of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaDepartment of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 Guangdong, ChinaBackground. 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.http://dx.doi.org/10.1155/2019/4130757 |
| spellingShingle | Wen-xiong Xu Hong-liang He Shun-wen Pan Yuan-li Chen Mei-ling Zhang Shu Zhu Zhi-liang Gao Liang Peng Jian-guo Li 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 Stem Cells International |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | http://dx.doi.org/10.1155/2019/4130757 |
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