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. 2020 Mar 31;10(3):64-78.
doi: 10.5500/wjt.v10.i3.64.

Novel alternative transplantation therapy for orthotopic liver transplantation in liver failure: A systematic review

Tomoaki Furuta  1 , Kinji Furuya  1 , Yun-Wen Zheng  1 , Tatsuya Oda  1
Affiliations

Novel alternative transplantation therapy for orthotopic liver transplantation in liver failure: A systematic review

Tomoaki Furuta et al. World J Transplant. .

Abstract

Background: Orthotopic liver transplantation (OLT) is the only treatment for end-stage liver failure; however, graft shortage impedes its applicability. Therefore, studies investigating alternative therapies are plenty. Nevertheless, no study has comprehensively analyzed these therapies from different perspectives.

Aim: To summarize the current status of alternative transplantation therapies for OLT and to support future research.

Methods: A systematic literature search was performed using PubMed, Cochrane Library and EMBASE for articles published between January 2010 and 2018, using the following MeSH terms: [(liver transplantation) AND cell] OR [(liver transplantation) AND differentiation] OR [(liver transplantation) AND organoid] OR [(liver transplantation) AND xenotransplantation]. Various types of studies describing therapies to replace OLT were retrieved for full-text evaluation. Among them, we selected articles including in vivo transplantation.

Results: A total of 89 studies were selected. There are three principle forms of treatment for liver failure: Xeno-organ transplantation, scaffold-based transplantation, and cell transplantation. Xeno-organ transplantation was covered in 14 articles, scaffold-based transplantation was discussed in 22 articles, and cell transplantation was discussed in 53 articles. Various types of alternative therapies were discussed: Organ liver, 25 articles; adult hepatocytes, 31 articles; fetal hepatocytes, three articles; mesenchymal stem cells (MSCs), 25 articles; embryonic stem cells, one article; and induced pluripotent stem cells, three articles and other sources. Clinical applications were discussed in 12 studies: Cell transplantation using hepatocytes in four studies, five studies using umbilical cord-derived MSCs, three studies using bone marrow-derived MSCs, and two studies using hematopoietic stem cells.

Conclusion: The clinical applications are present only for cell transplantation. Scaffold-based transplantation is a comprehensive treatment combining organ and cell transplantations, which warrants future research to find relevant clinical applications.

Keywords: Cell transplantation; Liver transplantation; Organ transplantation; Scaffold; Tissue engineering; Xenotransplantation.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of the study selection.
See this image and copyright information in PMC

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