CT confirms bone marrow stem cells boost liver tissue regeneration

Using a new approach to treat liver malignancies, researchers at Heinrich-Heine-University in Dusseldorf, Germany, have demonstrated that adult bone marrow stem cells accelerate the regeneration of healthy liver tissue in humans.

Portal vein embolization (PVE) is currently used to stimulate liver tissue growth for these patients. It redirects portal blood flow to the healthy portion of the liver to induce hypertrophy. In a study published in the April issue of Radiology, CT helped compare PVE with a combination of PVE and injected bone marrow stem cells in the liver.

Thirteen patients with central liver malignancies underwent PVE of liver segments I and IV to VIII to stimulate hepatic regeneration before hepatectomy. Researchers determined that PVE would be inadequate for six patients with future liver remnant volumes below 25% of presurgical liver volume and/or limited quality liver tissue. These patients were administered PVE and CD133+ bone marrow stem cells. The other seven patients, with future liver remnant volumes that were greater than 25%, received only PVE.

CT was used to measure liver and tumor volumes before and up to five weeks after PVE to determine liver growth. No labeling of the applied hematopoietic stem cells was performed.

Imaging revealed that the liver growth rate and gain in liver volume doubled in patients who received the combination of PVE and stem cell injection compared with those who underwent only PVE. The daily hepatic volume growth rate in the stem cell group averaged 9.5 mL per day compared with 4.1 mL per day in the PVE-only group.

The relative gain in future liver remnant volume (equivalent to the relative left lateral liver volume growth related to the preinterventional total liver volume) averaged 77.3% in the stem cell group and 39.1% in the group treated with PVE alone. As a result, patients who received the combined treatment could undergo surgery an average of 18 days sooner than patients who received PVE alone.

CD133+ cell implantation and PVE appear to be a potent combination, said coauthor Dr. Günter Fürst, a professor of radiology at Heinrich-Heine.

"Patients can minimize the possibility of tumor advance beyond resectability and shorten the waiting time to life-saving surgery," he said.

A randomized multicenter trial is planned. If the results are again positive, Fürst and collaborator Dr. Jan Schulte am Esch will test if stem cell-stimulated tissue regeneration can treat fulminant hepatic failure without preexisting liver disease and acute-on-chronic liver failure in cirrhotic patients.

For more information from the Diagnostic Imaging archives:

Report from ECR: Contrast-enhanced ultrasound shines in detecting liver metastases

Portal vein embolization provides hope in cancer

Labeling studies following human stem cell therapies