Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis

Chen-Hui Zhu; Dian-Han Zhang; Chen-Wei Zhu; Jing Xu; Chuan-Long Guo; Xiang-Gen Wu; Qi-Long Cao; Guo-Hu Di

doi:10.1186/s13287-021-02625-x

Adult stem cell transplantation combined with conventional therapy for the treatment of end-stage liver disease: a systematic review and meta-analysis

Stem Cell Res Ther. 2021 Oct 30;12(1):558. doi: 10.1186/s13287-021-02625-x.

Authors

Chen-Hui Zhu^#¹, Dian-Han Zhang^#¹, Chen-Wei Zhu^#¹, Jing Xu¹, Chuan-Long Guo², Xiang-Gen Wu², Qi-Long Cao³, Guo-Hu Di⁴

Affiliations

¹ School of Basic Medicine, Qingdao University, 308 Ningxia Road, Qingdao, 266071, China.
² College of Chemical Engineering, Qingdao University of Science and Technology, Qingdao, China.
³ Qingdao Haier Biotech Co. Ltd, Qingdao, China.
⁴ School of Basic Medicine, Qingdao University, 308 Ningxia Road, Qingdao, 266071, China. diguohu@qdu.edu.cn.

^# Contributed equally.

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.

Keywords: Adult stem cells; Conventional therapy; End-stage liver disease; Liver function; Stem cell transplantation.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adult
Adult Stem Cells*
End Stage Liver Disease* / therapy
Hematopoietic Stem Cell Transplantation*
Humans
Severity of Illness Index
Stem Cell Transplantation