Transplanted Liver Cells May Provide Treatment Option for End-Stage Liver Disease
Five U.S. Centers Experimenting With Cell Transplant
Dec.1, 1999 (Chicago) -- Every year, 5,000 Americans receive new livers and
a new lease on life. But for every person with end-stage liver disease, who is
the lucky recipient of a new liver, three more are left waiting on the
transplant list, and many of them will die waiting. Now an experimental
technique being tested at several centers in the U.S. may offer hope those who
wait for the gift of life: liver cell transplant.
Doctors at the Medical College of Virginia/Virginia Commonwealth University
and the University of Nebraska Medical Center are using cells gathered from
donor livers as either a bridge to transplant or bridge to recovery in patients
with end-stage liver disease. The papers were presented at the 85th Scientific
Assembly and Annual Meeting of the Radiological Society of North America.
Jaime Tisnado, MD, professor of cardiovascular and interventional radiology
and surgery, Medical College of Virginia/Virginia Commonwealth University,
Richmond, says his team has used the experimental procedure in 12 patients.
"One of the patients recovered with the infused cells alone and seven
are alive awaiting whole organ transplant," Tisnado tells WebMD. The woman
who recovered with just a cell transplant was in her mid-30s and had traumatic
liver damage, probably from a drug reaction. "When we transplanted her she
was bleeding out. The next morning, I went to check on her and she was up
eating breakfast. I couldn't believe it was the same woman." However, this
was an atypical case because the woman "had a healthy liver before the
acute injury to it, so we could infuse directly into the liver."
At Nebraska, William C. Culp, MD, assistant professor of radiology, and
colleagues have concentrated their efforts on pediatric patients. An
11-year-old girl who had a liver disease that caused excess amounts of
bilirubin, a substance produced by the liver, to accumulate in her blood was
required to spend 12 to 15 hours a day under ultraviolet lights as treatment, a
process called phototherapy. After the cell transplant, her bilirubin level
dropped dramatically, and now, "two years later, she is alive and
functioning although she still has to spend about four to six hours in
phototherapy," says Culp. Moreover, he says, "she came into the
hospital, had the transplant, and was discharged the next day. That's not a
transplant scenario, that's a tonsillectomy." His team has used liver cell
transplants in five patients, two of whom are still alive; three have died. His
other surviving patient was an infant who received an infusion at birth.
"He was sustained for five months until he could receive an organ
transplant," says Culp. The baby is now 1 year old.
Although the results are encouraging, Culp and Tisnado caution that their
work is still experimental. At Virginia, Tisnado is developing a technique to
freeze and bank the liver cells while the Nebraska team is "using cells
harvested from excess liver tissue [from a] transplant." Livers, Culp and
Tisnado explain, sometimes need to be pared down to "fit" the