人脐带间充质干细胞对肝移植术后缺血性胆管炎的疗效观察  

Umbilical cord-derived mesenchymal stromal cells transfusion for ischemic-type biliary lesions after liver transplantation:a phase I study

作　　者：张英才[1] 曾凯宁[1] 傅斌生[1] 张彤[1] 汪国营[1] 张彤[1] 陈良[1] 刘畅[2] 彭延文[2] 姜楠[1] 易述红[1] 张剑[1] 汪根树[1] 李华[1] 张琪[2] 杨扬[1] 陈规划 Zhang Hngcai Zeng Kaining FU Binsheng Zhang Tong Wang Guoying Chen Liang Liu Chang Peng Yanwen Jiang Nan Yi Shuhong Zhang Jian Wang Genshu Li Hual Zhang Qi Yang Yang Chen Guihua(Liver Transplant Center of the Third Affiliated Hospital of Sun Yat-sen University, Organ Transplantation Research Center of Guangdong Province, Guangzhou 510630, China Biotherapy Centre of the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China)

机构地区：[1]中山大学附属第三医院肝脏外科暨肝移植中心,中山大学器官移植研究所,广东省器官移植研究中心,广州510630 [2]中山大学附属第三医院细胞-基因治疗转化医学研究中心,广州510630

出　　处：《中华细胞与干细胞杂志（电子版）》2016年第5期280-283,共4页Chinese Journal of Cell and Stem Cell（Electronic Edition）

基　　金：国家863项目(2012AA02A600);国家自然科学基金(81300365、81370555、81370575、81570593);广东省自然科学基金研究团队项目(2015A030312013);广东省科技计划项目(20158020226004);广州市科技计划项目-健康医疗协同创新重大专项(158100076,201400000001-3);中山大学5010计划(2014006)

摘　　要：目的探讨人脐带间充质干细胞（MSC）治疗肝移植术后缺血性胆管炎（ITBL）的安全性和初步疗效。方法选取中山大学附属第三医院2013年1月至2014年12月期间12例肝移植术后ITBL患者，每例患者通过外周静脉输注6次MSC（1．0×10^6／kg）。从第1次MSC输注开始，所有患者随访至少随访48周。观察与MSC输注相关的短期和长期不良事件。通过肝功能等检测，评估MSC治疗ITBL的初步效果。患者治疗前后肝功能数据的比较采用单向方差分析。结果随访到2015年3月截至，平均随访时间为（20．1±4．2）个月。除1例出现自限性发热（37．6℃）外，未发现与MSC相关的不良事件，无患者死亡和移植物丢失。与治疗前基线比较，12例患者总胆红素在20周评估时有7例（5813％）好转，3例稳定（25．0％）和2例（16．7％）恶化；在48周评估时有7例（58_3％）好转，2例（16．7％）稳定和3例（25．0％）恶化（F=2．917，P=0．068）。结论MSC在肝移植患者应用是安全可行的，初步结果提示其对ITBL患者具有较好的短期治疗效果，有望成为治疗ITBL新的治疗手段。Objective To evaluate the safety and efficacy of umbilical cord-derived mesenchymal stem cells （UC-MSC） transfusion for patients with ischemic-type biliary lesions （ITBLs） after liver transplantation. Methods From Jan. 2013 to Dec. 2014, 12 recipients developed ITBLs after liver transplantation in our hospital were recruited in this trial. Patients receive six doses of UC-MSCs （about 1.0× 10^6 MSCs per kilogram body weight） through peripheral intravenous infusion. Liver function tests were performed to evaluate the progress of ITBLs. Adverse events and graft survival were also observed up to 48 weeks after MSCs transfusion. All data were analyzed by paired sample t-test. Results No significant MSCs-related adverse events and no graft loss were observed during the trial except that fever（37.6℃ ） was found in one case. Improved, stable and worse outcomes of biliary enzyme index were observed in 58.3 % （7/12）, 25.0 % （3/12） and 16.7 % （2/12）patients at 20 weeks, and 58.3 % （7/12）, 16.7% （2/12） and 25.0% （3/12） patients at 48 weeks after MSC transfusion. Coneluslon The UC-MSC transfusions in liver transplant recipients with ITBLs are clinically safe and effective in the short term and may become a promising therapeutic agent for patients with ITBLs after liver transplantation.

关 键 词：间质干细胞 脐带 胆管炎 肝移植 

分 类 号：R657.3[医药卫生—外科学]