A Clinic Study on Long-term Efficacy and Safety of Autologous Peripheral Blood Stem Cell Transplantation in Patients with Decompensated Hepatitis B Cirrhosis.

Objective: To investigate the long-term safety and efficacy of autologous peripheral blood stem cell transplantation (APBSCT) in treating decompensated hepatitis B cirrhosis. Methods: In this study, a retrospective analysis was conducted on a cohort of 84 patients diagnosed with decompensated hepatitis B cirrhosis between January 2011 and December 2012. The patients were categorized into two groups based on their treatment approach: the transplantation group, consisting of 34 cases who received APBSCT in addition to medical treatment, and the comprehensive medical treatment (CMT) group, comprising 50 cases who solely received CMT. EPI Data software was used for data input and verification. Survival curves were drawn by Kaplan-Meier method and analyzed by log-rank test. Paired t test and independent sample t test were used for intra-group and inter-group mean comparison of measurement data, respectively. The Mann-Whitney U test is used for non-normally distributed data. Results: After the ten-year follow-up period, it was found that overall survival (OS) in the transplantation group was markedly higher than that in the CMT (56% vs. 16%, P < .001). Albumin (ALB), prothrombin time (PT), and indocyanine green retention at 15 min (ICG R15) were significantly improved in sequence at 4 to 12 weeks of early treatment in APBSCT group; subsequently, the Acoustic radiation force impulse (ARFI) index and spleen length significantly decreased at 48 weeks. Compared with the CMT group, ALB and PT levels in the APBSCT group continued to recover and eventually stabilize at normal or low-risk levels at subsequent follow-ups up to 8 years. The ten-year prevalence of hepatocellular carcinoma (HCC) in the APBSCT group was markedly lower than that in the CMT group (26% vs. 62%; P = .025). Moreover, APBSCT significantly reduced ascites (χ2 = 6.997, P = .041) and was not associated with any significant adverse events during APBSCT. Based on clinical evidence, APBSCT is a safe and effective treatment for decompensated hepatitis B cirrhosis, resulting in a favorable long-term prognosis with no significant adverse events. Conclusions: APBSCT is a relatively safe and effective treatment for decompensated hepatitis B cirrhosis.

Effectiveness and Safety of Stem Cell Therapy in Liver Cirrhosis: A Meta-Analysis of Randomized Controlled Trials.

Objective: In recent years, stem cell transplantation (SCT) has been applied to the clinical treatment of patients with cirrhosis. The specialist clinic of the SCT clinic provides regular and effective interventions for cirrhosis, helping to improve patient management and compliance. The aim of this study was to determine the efficacy and safety of SCT in the treatment of cirrhosis. Methods: This systematic review adhered to the guidelines outlined in the PRISMA statement. The National Library of Medicin (MEDLINE), Excerpt Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), and Clinical Trials.gov databases were searched to screen liver cirrhosis-related articles with stem cell therapy from 2000 to 2022. The articles were then filtered and extracted for clinical outcomes including MELD score, Child-Pugh score, platelets, creatinine, bilirubin, albumin, international normalized ratio (INR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), alkaline phosphatase (ALP), α fetoprotein (AFP), prothrombin time (PT). The data were normalized and analyzed using the standardized mean difference (SMD) and 95% confidence interval (CI). Results: A total of 1209 articles were searched, and from these, ten studies were selected for analysis regarding the association between SCT and the clinical outcomes of liver cirrhosis. The findings revealed that SCT therapy, in comparison to conventional treatment, resulted in a reduction in MELD score and INR after 1 month, a decrease in Child-Pugh score at 3 months, an increase in platelet count at 3 months, and an elevation in ALB levels after 1 month. However, no significant beneficial effects were observed on creatinine, bilirubin, PT, ALT, AST, GGT, ALP, and ASP levels. Conclusion: This study suggested that SCT therapy could elevate the ALB levels and alleviate the MELD score and INR, short-term decreasing the Chile-Pugh score and increasing the platelet levels. It could be a potential therapeutic alternative for patients with cirrhosis.