Treating patients with liver cirrhosis by BMT Liu

Treating patients with liver cirrhosis by BMT Liu Baochi Shanghai Public Health Clinical Center affiliated to Fudan University

BACKGROUND Decompensated liver cirrhosis is difficult to cure liver cirrhosis with AIDS is more difficult to give effective treatment Stem cell treatment bring the hope for the patients of AIDS with decompensated liver cirrhosis.

Patients 7 AIDS patients with decompensated liver cirrhosis and portal ven hypertention , ascites, internal blooding were investigated.

Methods Splenectomy were performed in 7 AIDS patients with liver cirrhosis to alleviate portal vein hypertention and avoid internal blooding.

During the surgical procedure, a catheter was placed in the superior mesenteric vein in preparation for bone marrow transfusion (BMT).

Methods 20 m. L bone marrow was aspirated by puncture of the iliac crest one week after surgery and transfused through the attached catheter into the portal vein.

Methods One or two doses of BMT were performed on each patient at a one month interval.

Results Except diminishment of ascites and recovery of serum albumin levels, total white blood cells and platelet count was also significantly improved. Unexpectedly, one month after BMT, CD 4+ T cell count in peripheral blood of all 7 patients began to increase significantly.

changes of CD 4+ T lymph cell ( /ul) age before 1 month 3 month 12 month 24 month 56 61 81 269 341 512 36 80 120 366 519 541 32 27 41 130 265 141 244 289 235 411 999 326 612 1112 776 636 1126 35 39 303 491 864 768 1087 1127 changes of CD 8+ T lymph cell ( /ul) age before 1 month 3 month 12 month 24 month 56 228 318 368 512 825 36 529 621 686 648 796 32 27 41 256 324 312 362 649 462 418 1886 542 478 1892 968 639 1896 35 39 174 680 269 826 1486 2327

changes of albumin（g/L） age before 1 month 3 month 12 month 24 month 56 30. 8 34. 1 34. 6 38. 6 40. 1 36 33. 5 35. 6 36. 8 38. 9 32 27 41 27. 4 36. 3 31. 3 38. 2 36. 8 28. 6 37. 9 38. 6 34. 2 38. 1 39. 6 38. 2 38. 8 41. 1 35 39 37 34. 1 39. 4 38. 4 36. 3 39. 2 changes of Tbl（umol/L） age before 1 month 12 month 24 month 13. 6 3 month 16．4 56 12. 9 16. 1 15, 2 36 48. 2 38. 6 31. 6 28. 4 26. 4 32 27 41 56. 9 16. 7 57. 5 38. 9 18. 9 65. 5 32. 4 18. 1 42. 6 26. 8 17. 9 31. 5 31. 6 16. 6 35 39 21. 8 19. 2 16. 4 8. 5 14. 2

changes of WBC（× 109/L） age 55 36 32 27 41 before 2. 1 1. 89 2. 14 2 2. 54 1 month 6. 6 7. 6 3. 9 8. 9 11. 4 3 month 5．4 6. 6 5. 4 7. 1 8. 6 35 39 3. 35 5. 55 5. 1 5. 4 7. 4 6. 4 12 month 5. 1 6. 4 5. 8 6. 9 7. 6 24 month 6, 2 5. 4 5. 6 6. 5 changes of Plate（× 109/L） age 55 36 32 27 41 before 36 26. 7 101 56 28 1 month 306 296 412 419 177 3 month 286 326. 4 346 427 286 35 39 16 133 153 312 187 342 12 month 254. 6 284 264. 6 310 288 24 month 268 246 289

changes of Hb（g/L） age before 1 month 3 month 12 month 24 month 55 107 109 114 126 132 36 88. 6 102. 6 129 132 112 32 27 41 63. 3 55 87 89. 4 94. 2 109 121 118 112 131 121 118 134 128 35 39 125 60 130 88 119 96 changes of PT(秒) age before 1 month 3 month 12 month 24 month 56 17 15. 2 14 14. 2 13. 6 36 19. 1 14. 8 13. 6 14 14. 1 32 27 41 17. 9 18. 3 22. 1 16 14. 1 17. 9 14. 4 14. 6 16. 2 13. 8 14. 2 14. 4 14. 2 14. 1 35 39 19. 1 17. 1 14. 6 15. 8 14. 3 14. 9

liver cirrhosis and highly enlarged spleen with huge amout of ascites before operation four months after operation and BMT. Ascites disappeared and liver enlarged

Clinical significance of BMT It may change the standard of liver transplantation

Conclusion BMT for the AIDS patient with liver cirrhosis can promote liver function and immune reconstruction.