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Three Cases of Alcohol-Induced Acute-On-Chronic Liver Failure With Successful Support by Adipose-Derived Stem Cells.
Clinical and Translational Gastroenterology ( IF 3.0 ) Pub Date : 2019-12-01 , DOI: 10.14309/ctg.0000000000000095
Tobias Götze 1 , Michael Krueger 2 , Juliane Meutsch 2 , Max Dörfel 2 , Stephan Born 2 , Jan-Peter Sowa 1 , Ali Canbay 1
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OBJECTIVES Acute liver failure (ALF) and acute-on-chronic liver failure (AOCLF) are critical medical conditions with urgent therapy requirements. When ALF or AOCLF are due to alcohol intoxication or based on chronic alcohol abuse, virtually, no therapeutic options are available as liver transplantation is prohibited. In this case series, treatment of alcohol-induced ALF/AOCLF with adipose--derived stem cells (ASC) was tested under compassionate use. METHODS ASC from 2 donors were isolated, cultured, and expanded by established protocols. ASC were administered to 3 individuals with either ALF or AOCLF due to alcohol abuse under compassionate use. Clinical presentation, serum measurements, and other diagnostic methods were compiled before ASC treatment and during the disease course after ASC administration. RESULTS Three patients were admitted to the Department of Gastroenterology, Hepatology, and Infectious Diseases (University Hospital Magdeburg) with acute or AOCLF due to alcohol abuse. All 3 patients presented in impaired general condition and with elevated, in 1 case drastically elevated, serum liver enzyme concentrations. Treatment with ASC led to improvements in general condition and reduction of serum transaminases. In 2 cases, reduction of liver stiffness and increase of liver function by the C methacetin breath test were observed after ASC treatment. Recovery to a normal condition was achieved between 1 and 2 months after ASC treatment. No adverse effects associated to ASC treatment were observed. DISCUSSION ASC treatment may be a feasible option to enhance recovery from alcohol-induced ALF or AOCLF. ASC treatment seems safe in the presented cases.

中文翻译:

三例由酒精衍生的干细胞成功支持的酒精诱发的急性慢性肝衰竭。

目的急性肝衰竭(ALF)和慢性慢性肝衰竭(AOCLF)是需要紧急治疗的关键医学疾病。当ALF或AOCLF是由于酒精中毒或基于长期酒精滥用而来时,实际上,由于肝移植被禁止,因此没有任何治疗选择。在本案例系列中,在同情使用下测试了使用脂肪衍生干细胞(ASC)治疗酒精诱导的ALF / AOCLF。方法按照既定方案分离,培养和扩增2位供体的ASC。因同情使用导致酗酒,对3名患有ALF或AOCLF的人给予ASC。在ASC治疗之前和ASC施用后的疾病过程中,汇编了临床表现,血清测量值和其他诊断方法。结果3例因滥用酒精而患有急性或AOCLF的消化道,肝病和传染病科(马格德堡大学医院)被收治。所有3例患者的一般状况均受损,血清肝酶浓度升高(其中1例急剧升高)。ASC治疗可改善一般状况并降低血清转氨酶。在2例患者中,ASC治疗后观察到美沙西丁C呼气试验降低了肝脏的硬度,并增强了肝功能。ASC治疗后1到2个月内恢复到正常状态。没有观察到与ASC治疗相关的不良反应。讨论ASC治疗可能是增强从酒精诱导的ALF或AOCLF中恢复的可行选择。
更新日期:2019-11-01
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