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Titolo:
HEPATOCYTE TRANSPLANTATION AS A BRIDGE TO ORTHOTOPIC LIVER-TRANSPLANTATION IN TERMINAL LIVER-FAILURE
Autore:
STROM SC; FISHER RA; THOMPSON MT; SANYAL AJ; COLE PE; HAM JM; POSNER MP;
Indirizzi:
VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,DEPT SURG,BOX 980254,MCVSTN RICHMOND VA 23298 VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,DEPT SURG RICHMOND VA 23298 VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,DEPT GASTROENTEROL RICHMOND VA 23298 VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,DEPT PATHOL RICHMOND VA 23298 VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA,DEPT RADIOL RICHMOND VA 23298
Titolo Testata:
Transplantation
fascicolo: 4, volume: 63, anno: 1997,
pagine: 559 - 569
SICI:
0041-1337(1997)63:4<559:HTAABT>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
FULMINANT HEPATIC-FAILURE; MICROCARRIER-ATTACHED HEPATOCYTES; PARTIALLY HEPATECTOMIZED RATS; GROWTH-FACTOR; BIOARTIFICIAL LIVER; HEPATOCELLULAR TRANSPLANTATION; CARBAMOYLPHOSPHATE SYNTHETASE; CELL TRANSPLANTATION; GLUTAMINE-SYNTHETASE; GENE-THERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
67
Recensione:
Indirizzi per estratti:
Citazione:
S.C. Strom et al., "HEPATOCYTE TRANSPLANTATION AS A BRIDGE TO ORTHOTOPIC LIVER-TRANSPLANTATION IN TERMINAL LIVER-FAILURE", Transplantation, 63(4), 1997, pp. 559-569

Abstract

The limited donor organ supply has led to several bridging techniquesto sustain patients with acute and subacute liver failure, We report here the prospective, controlled trial of transplanted isolated fresh and cryopreserved human hepatocytes as a bridge to orthotopic liver transplantation. Five hepatocyte transplant recipients with grade IV encephalopathy and multisystem organ failure and four patients of equal illness severity due to liver failure were studied, Medical therapy resulted in a significant (P<0.05), but not normal, fall in blood ammonia, and a significant (P<0.02) resolving biochemical marker of liver injury that did not improve cardiovascular or cerebral stability; this lead to death within 3 days in all control patients, The five hepatocyte-treated patients maintained normal cerebral perfusion and cardiac stability, with withdrawal of medical support for 2 to 10 days before orthotopic liver transplantation. Biochemical evidence of liver injury improved significantly (P=0.004) and blood ammonia levels decreased significantly (P=0.0005) to normal levels in the hepatocyte-treated patients, Three of five patients who successfully bridged to whole liver allograft transplant are alive, home, and normal with more than 20 monthsof follow-up, No infections or embolic or pulmonary complications resulted from intra-arterial splenic hepatocyte infusion, Specific antiprotease production in a patients with genetically deficient alpha-1-antitrypsin disease, and immunohistochemical and electron microscopic evidence of splenic ''hepatization'' are presented as evidence of the viability of hepatocyte splenic seeding, In conclusion, splenic transplantation of differentiated adult hepatocytes can control hyperammonemia,correct genetic defects in liver function, and bridge life to orthotopic liver transplantation in human liver failure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/21 alle ore 15:10:49