Regenerative therapy for liver cirrhosis: efficacy of intraportal administration of autologous bone marrow mononuclear cells

Objective: to evaluate the efficacy and safety of cell therapy in hepatocellular insufficiency due to liver cirrhosis. Material and methods. The study (conducted at the S.P. Botkin Moscow Clinical and Research Center) included 58 patients: 19 received intraportal infusion of autologous bone marrow mononuclear cells (BM-MNCs), 19 underwent G-CSF therapy, and 20 received conservative treatment (control group). The groups were comparable in terms of sex, age, and severity of liver failure. CD34+ cell mobilization was performed using a gravitational separator. Follow-up was conducted at 14, 30, 90 days, and 1 year; histological analysis was performed before and 2 months after treatment. Results. The BM-MNC group showed the greatest reduction in MELD-Na scores (by 5.22 ± 2.79 at 3 months), a rapid decline in bilirubin levels (by 30.6 μmol/L by day 14), and a steady increase in albumin. The period of clinical compensation was 180 ± 12.6 days. Histological examination after BM-MNC infusion revealed positive changes: reduced lymphoid infiltration in portal tracts in 17 patients (89.5%). In two cases, liver architecture was restored, and in one case, fibrosis regression (F3) was observed. Evaluation of CD68+ macrophages at 2 months showed a decrease in levels 15% and more in 13 cases (68.4%). Conclusion. Intraportal BM-MNC infusion is an effective and safe method for correcting hepatocellular insufficiency, as confirmed by clinical, laboratory, and histological data. 

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