Introduction of Mesenchymal Stem Cells for Liver Surgery (Hepatectomy and Transplantation)

Excerpt

In liver transplantation, prolonged ischemia and/or a relatively small graft (living, split, reduced) are the risk factors for liver dysfunction. Novel measures to enhance liver function with a smaller graft can be a clue for safe partial or living-donor liver transplantation or safe hepatectomy for malignant disease. The therapeutic potential and immunomodulatory effects of mesenchymal stem cells (MSCs) have been reported. In this chapter, recent finding on the positive effect of MSCs for liver transplantation and hepatectomy are discussed.

Our rat experiment revealed that introduction of MSCs provides trophic support to the I/R-injured liver by inhibiting hepatocellular apoptosis and by stimulating regeneration, which is shown with the pig model as well. In the rat liver transplantation model, portal transfusion of the MSCs ameliorates the injury of the liver graft after prolonged cold preservation and transplantation. Those findings together suggest a potential advantage with partial or living-donor liver transplantation. The most severe complication with cell therapy is embolus formation due to cell aggregation. However, with modification of the solution, we can keep cells in a suspended form for several hours, which secures safe administration of MSCs.