Application of simplified protocol combining with mesenchymal stem cell in ABO-incompatible liver transplant patients

doi:10.3877/cma.j.issn.2095-3232.2016.06.009

Abstract

Abstract:

Objective

To investigate the safety and feasibility of a simplified protocol combining with mesenchymal stem cell (MSC) in ABO-incompatible (ABO-I) liver transplant patients.

Methods

Twelve ABO-I liver transplant patient who received the therapy of a simplified protocol combining with MSC in the Third Affiliated Hospital of Sun Yat-sen University between January 2014 and September 2015 were recruited in this prospective study. Ten cases were male and 2 were female, with a mean age of (39±13) years old. The informed consents of all patients or their families were obtained and the local ethical committee approval was received. A immunologic tolerance induction protocol, plasma exchange + rituximab + intravenous immunoglobin + MSC (simplified protocol combining with MSC and without splenectomy and graft local infusion), was used to prevent the antibody-mediated rejection (AMR) after liver transplantation (LT). The perioperative condition and postoperative outcome of the patients were observed.

Results

Three death cases were observed after LT including 2 cases died of multiple organ failure and 1 of gastrointestinal hemorrhage. The other cases survived. Two cases developed acute cellular rejection and no AMR case was observed. Biliary complication was observed in 3 cases, hepatic artery stenosis in 1 case and infection in 6 cases.

Conclusion

The simplified protocol combining with MSC is safe and effective in preventing the AMR after ABO-I LT.

Key words: Mesenchymal stem cells, Liver transplantation, ABO blood-group system, Blood group incompatibility, Immunosuppression

Yingcai Zhang, Jia Yao, Yinan Deng, Liang Chen, Kaining Zeng, Qing Yang, Guoying Wang, Bingsheng Fu, Tong Zhang, Nan Jiang, Huimin Yi, Genshu Wang, Jian Zhang, Shuhong Yi, Hua Li, Qi Zhang, Yang Yang, Guihua Chen. Application of simplified protocol combining with mesenchymal stem cell in ABO-incompatible liver transplant patients[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2016, 05(06): 380-384.

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URL: https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3232.2016.06.009

https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/Y2016/V05/I06/380

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