간경변 환자에서 제대혈 유래 간엽줄기세포 이식술의 초기 임상결과 분석

Abstract

Liver transplantation is the accepted method of treatment for end stage liver disease. Development of various immunosuppressive drugs and advances in the surgical techniques have led to the improvement in patient and graft survival. The number of donor for liver transplantation, however, is in shortage seriously in contrast to growing numbers of patients. Such gap between liver- donor and recipient becomes the major limitation of liver replacement therapy. So we need to find an alternative, effective and safe therapeutic method to treat liver cirrhosis. The use of human hepatocytes in the management of various liver based metabolic conditions and acute and chronic liver failure suggested us some possibility . The understanding of the process of self-renewal and differentiation of the stem cell has both changed and progressed over the last few decades. For many years, the assumption was that the liver regenerates primarily through the division of mature liver cells. However, over the last few years there has been increasing evidence of the participation of stem cells. In addition, extrahepatic stem cells may migrate from the bone marrow into the liver when the regenerative capacity of the liver itself is depleted. It is not yet fully clear how the different stem cell populations interact with both each other and the mature liver cell population to achieve homeostatic cell and differentiation equilibrium in the diseased and/or regenerating organ. In any case, the outstanding growth potential of liver stem cells may become a clinically viable option in the field of cell transplantation. There are many papers that the mesenchymal stem cells could be isolated from human umbilical cord blood and the differentiation into muscle, nerve cell, endothelial cell and hepatocyte could be possible. And I tried clinical application in Buerger`s disease and liver cirrhosis and had the very promising results. Here I report the early results of Umbilical Cord Blood Stem Cell Transplantation for Liver cirrhosis. The general conditions and the laboratory data of the patients changed very positively. And CT volumetry of the treated cirrhotic liver gave us the possibility of the cure and the clue of the mechanism of the stem cell as we already had the good results of angiography in Buerger`s disease. Transplantation of UCB stem cell for liver cirrhosis is not curative treatment modality at present but seems to be the curative one in the future by the basic research of the stem cell and some modification of the purification and culture methods and some development of route of administration of the UCB stem cell.