Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis
Abstract End-stage liver disease (ESLD) is characterized by the deterioration of liver function and a subsequent high mortality rate. Studies have investigated the use of adult stem cells to treat ESLD. Here, a systematic review and meta-analysis was conducted to determine the efficacy of a combinat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Stem Cell Research & Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13287-021-02625-x |
| _version_ | 1818732380674850816 |
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| author | Chen-Hui Zhu Dian-Han Zhang Chen-Wei Zhu Jing Xu Chuan-Long Guo Xiang-Gen Wu Qi-Long Cao Guo-Hu Di |
| author_facet | Chen-Hui Zhu Dian-Han Zhang Chen-Wei Zhu Jing Xu Chuan-Long Guo Xiang-Gen Wu Qi-Long Cao Guo-Hu Di |
| author_sort | Chen-Hui Zhu |
| collection | DOAJ |
| description | Abstract End-stage liver disease (ESLD) is characterized by the deterioration of liver function and a subsequent high mortality rate. Studies have investigated the use of adult stem cells to treat ESLD. Here, a systematic review and meta-analysis was conducted to determine the efficacy of a combination therapy with adult stem cell transplantation and traditional medicine for treating ESLD. Four databases—including PubMed, Web of Science, Embase, and Cochrane Library—were investigated for studies published before January 31, 2021. The main outcome indicators were liver function index, model for end-stage liver disease (MELD) scores, and Child‒Turcotte‒Pugh (CTP) scores. Altogether, 1604 articles were retrieved, of which eight met the eligibility criteria; these studies included data for 579 patients with ESLD. Combination of adult stem cell transplantation with conventional medicine significantly improved its efficacy with respect to liver function index, CTP and MELD scores, but this effect gradually decreased over time. Moreover, a single injection of stem cells was more effective than two injections with respect to MELD and CTP scores and total bilirubin (TBIL) and albumin (ALB) levels, with no significant difference in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. With respect to the TBIL levels, patients receiving mononuclear cells (MNCs) experienced a significantly greater therapeutic effect—starting from twenty-four weeks after the treatment—whereas with respect to ALB levels, CD34+ autologous peripheral blood stem cells (CD34+ APBSCs) and MNCs had similar therapeutic effects. Severe complications associated with adult stem cell treatment were not observed. Although the benefits of combination therapy with respect to improving liver function were slightly better than those of the traditional treatment alone, they gradually decreased over time. Systematic review registration: PROSPERO registration number: CRD42021238576. |
| first_indexed | 2024-12-17T23:32:39Z |
| format | Article |
| id | doaj.art-c36a14fe36c245c1ba5540df355e9cf3 |
| institution | Directory Open Access Journal |
| issn | 1757-6512 |
| language | English |
| last_indexed | 2024-12-17T23:32:39Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Stem Cell Research & Therapy |
| spelling | doaj.art-c36a14fe36c245c1ba5540df355e9cf32022-12-21T21:28:38ZengBMCStem Cell Research & Therapy1757-65122021-10-0112111810.1186/s13287-021-02625-xAdult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysisChen-Hui Zhu0Dian-Han Zhang1Chen-Wei Zhu2Jing Xu3Chuan-Long Guo4Xiang-Gen Wu5Qi-Long Cao6Guo-Hu Di7School of Basic Medicine, Qingdao UniversitySchool of Basic Medicine, Qingdao UniversitySchool of Basic Medicine, Qingdao UniversitySchool of Basic Medicine, Qingdao UniversityCollege of Chemical Engineering, Qingdao University of Science and TechnologyCollege of Chemical Engineering, Qingdao University of Science and TechnologyQingdao Haier Biotech Co. LtdSchool of Basic Medicine, Qingdao UniversityAbstract End-stage liver disease (ESLD) is characterized by the deterioration of liver function and a subsequent high mortality rate. Studies have investigated the use of adult stem cells to treat ESLD. Here, a systematic review and meta-analysis was conducted to determine the efficacy of a combination therapy with adult stem cell transplantation and traditional medicine for treating ESLD. Four databases—including PubMed, Web of Science, Embase, and Cochrane Library—were investigated for studies published before January 31, 2021. The main outcome indicators were liver function index, model for end-stage liver disease (MELD) scores, and Child‒Turcotte‒Pugh (CTP) scores. Altogether, 1604 articles were retrieved, of which eight met the eligibility criteria; these studies included data for 579 patients with ESLD. Combination of adult stem cell transplantation with conventional medicine significantly improved its efficacy with respect to liver function index, CTP and MELD scores, but this effect gradually decreased over time. Moreover, a single injection of stem cells was more effective than two injections with respect to MELD and CTP scores and total bilirubin (TBIL) and albumin (ALB) levels, with no significant difference in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. With respect to the TBIL levels, patients receiving mononuclear cells (MNCs) experienced a significantly greater therapeutic effect—starting from twenty-four weeks after the treatment—whereas with respect to ALB levels, CD34+ autologous peripheral blood stem cells (CD34+ APBSCs) and MNCs had similar therapeutic effects. Severe complications associated with adult stem cell treatment were not observed. Although the benefits of combination therapy with respect to improving liver function were slightly better than those of the traditional treatment alone, they gradually decreased over time. Systematic review registration: PROSPERO registration number: CRD42021238576.https://doi.org/10.1186/s13287-021-02625-xEnd-stage liver diseaseStem cell transplantationConventional therapyAdult stem cellsLiver function |
| spellingShingle | Chen-Hui Zhu Dian-Han Zhang Chen-Wei Zhu Jing Xu Chuan-Long Guo Xiang-Gen Wu Qi-Long Cao Guo-Hu Di Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis Stem Cell Research & Therapy End-stage liver disease Stem cell transplantation Conventional therapy Adult stem cells Liver function |
| title | Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis |
| title_full | Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis |
| title_fullStr | Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis |
| title_full_unstemmed | Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis |
| title_short | Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis |
| title_sort | adult stem cell transplantation combined with conventional therapy for the treatment of end stage liver disease a systematic review and meta analysis |
| topic | End-stage liver disease Stem cell transplantation Conventional therapy Adult stem cells Liver function |
| url | https://doi.org/10.1186/s13287-021-02625-x |
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