Guenter Fuerst, Presenter: Nothing to Disclose

Lars Benjamin Fritz MD,PhD, Abstract Co-Author: Nothing to Disclose

Ali Ghodsizad MD, Abstract Co-Author: Nothing to Disclose

Jan Schulte am Esch, Abstract Co-Author: Nothing to Disclose

Ludger Wilhelm Poll MD, Abstract Co-Author: Nothing to Disclose

Wolfram T. Knoefel MD, Abstract Co-Author: Nothing to Disclose

Stefan B Hosch, Abstract Co-Author: Nothing to Disclose

Ulrich Moedder MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To investigate the combination of autologous cluster of differentiation (CD)133+ bone marrow stem cell (BMSC) administration to the liver with portal vein embolization (PVE) versus PVE alone to improve hepatic regeneration prior to extended right hepatectomy in patients with large malignant hepatic lesions.

Thirteen patients with hepatic malignancies who underwent PVE of segments I and IV-VIII for regeneration stimulation were evaluated. In 6 patients (mean age, 61 yrs; range, 46-72 yrs; 3 women, 3 men) with a future liver remnant volume (FLRV) below 20% and/or limited quality of hepatic parenchyma PVE alone did not promise adequate hepatic proliferation. These patients underwent intraportal application of CD133+ BMSCs to liver segments II and III (group I). In 7 patients (mean age, 69 yrs; range, 63-75 yrs; 3 women, 4 men) with a FLRV below 25% PVE alone promised adequate proliferation (group II). Two blinded radiologists measured total liver volume, tumor volume and FLRV prior to and 2-5 weeks after PVE using helical CT. Absolute, relative and daily FLRV gains were compared using two-samples t test for unequivocal variances.

The increase of the mean absolute FLRV in group I from 239.3 ml (SD, 103.5 ml) to 417.1 ml (SD, 150.4 ml) was higher than in group II from 286.3 ml (SD, 77.1 ml) to 395.9 ml (SD, 94.1 ml) (p=0.036). The relative gain of the FLRV after PVE (mean±SD) in group I (77.3±38.2%) was higher than in group II (39.1±20.4%) (p=0.032). The daily hepatic growth rate in group I (9.5±4.3 ml/day) was superior to group II (4.1±1.9 ml/day) (p=0.012). Time to surgery in group I was 27±11 days, and in group II 45±21 days (p=0.057). No complications associated with the BMSC application were observed.

In patients with large malignant liver lesions the combination of PVE and CD133+ stem cell administration significantly improves hepatic regeneration compared to PVE alone. Patients with small FLRV and limited quality of hepatic parenchyma may benefit from reduced time to surgery.

CD133+ BMCS application in addition to PVE can improve hepatic regeneration and reduce time-to-surgery in patients scheduled for extended right hepatectomy.

Fuerst, G, Fritz, L, Ghodsizad, A, Schulte am Esch, J, Poll, L, Knoefel, W, Hosch, S, Moedder, U, et al, , Portal Vein Embolization and Application of Autologous CD133+ Bone Marrow Stem Cells to Support Liver Regeneration.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4427337.html