Scientists have, for the first time, found that stem cells, taken from the patients' bone marrow and injected into the diseased liver, can keep them alive until donor organs become available. Miraculously, the cells can also support liver function, until the organ is able to regenerate itself, eliminating the need for a transplant at all.
The demand for liver donors is very high and many patients die waiting for one or are taken off because their condition deteriorates to the extent that they would not survive the operation when their turn finally arrives. A longstanding goal in hepatology has been to achieve suppression of liver cell death until regeneration could occur.
In a series of animal studies, Massachusetts General Hospital researchers successfully treated rats with liver diseases by manipulating their immune response. If this procedure can be repeated in humans, it could potentially reduce the number of donor organs used in urgent transplant procedures, thereby increasing the number available for the patients on waiting lists.
For example in India, 15,000 people require a liver transplant every year. Shockingly, only 150 get lucky. India requires 22,000 donors annually. Doctors say they get only 50 donors a year.
Eminent liver transplant specialist Dr A K Soin from Sir Gangaram Hospital said, "This therapy can be promising for patients with acute liver failure in whom the effect of liver failure can prove fatal before the patient's liver has had a chance to regenerate.
The technique can be an important bridge to liver recovery. If it can support liver function for a few weeks, then it will give time for the patient's liver to regenerate."
The researchers used mesenchymal stem cells (MSCs) — cells from the bone marrow that develop into tissues supporting blood cell development in the marrow cavity. Previous research has shown that mesenchymal stem cells are able to inhibit several immune system activities, apparently by putting a break on the movement of immune cells to areas of damage.
The researchers tested several ways of using the cells to treat rats with liver failure. Simply transplanting mesenchymal stem cells into the animals' livers did not work.
Two subsequent methods of delivering molecules secreted by cells lessened inflammation within the liver and halted cell death.