OBJECTIVE: This study was designed to evaluate the clinical outcome of patients undergoing portal vein embolization (PVE) and autologous CD133 bone marrow-derived stem cell (CD133+ BMSC) application before extended right hepatectomy. BACKGROUND: We have previously shown that portal venous infusion of CD133+ BMSCs substantially increases hepatic proliferation, when compared with PVE alone. METHODS: : Among 40 consecutive patients with a median follow-up of 28 months (7.4-57.2) scheduled for extended right hepatectomy, we compared a preconditioned group with PVE and CD133+ BMSC cotreatment (PVE+SC group, n = 11) and a group pretreated only with PVE (PVE group, n = 11). Functional and overall outcomes after extended right hepatectomy were evaluated. Patients without presurgical treatment served as controls (n = 18). RESULTS: In preconditioned patients, mean hepatic growth of segments II/III 14 days after PVE in the PVE+SC group was significantly higher (138.66 mL ± 66.29) when compared with that of PVE group patients (62.95 mL ± 40.03; P = 0.004). There were no significant differences among all 3 groups regarding general and oncological characteristics and functional parameters on postoperative day (POD) 7. Lack of hepatic preconditioning, extrahepatic extension of resection, and postoperative complications were of negative prognostic value, using univariate analysis (P < 0.05). In multivariate analysis, freedom from postoperative major complications (P = 0.012), coagulation status on POD 7 (international normalized ratio < 1.4; P = 0.027), and presurgical expansion of the future liver remnant volume (P = 0.048) were positively associated with overall survival. Post hoc analysis revealed a better survival for the PVE+SC group (P = 0.028) compared with the PVE group (P = 0.094) and compared with controls. CONCLUSION: Promising data from this survival analysis suggest that PVE, together with CD133+ BMSC pretreatment, could positively impact overall outcomes after extended right hepatectomy.
OBJECTIVE: This study was designed to evaluate the clinical outcome of patients undergoing portal vein embolization (PVE) and autologous CD133 bone marrow-derived stem cell (CD133+ BMSC) application before extended right hepatectomy. BACKGROUND: We have previously shown that portal venous infusion of CD133+ BMSCs substantially increases hepatic proliferation, when compared with PVE alone. METHODS: : Among 40 consecutive patients with a median follow-up of 28 months (7.4-57.2) scheduled for extended right hepatectomy, we compared a preconditioned group with PVE and CD133+ BMSC cotreatment (PVE+SC group, n = 11) and a group pretreated only with PVE (PVE group, n = 11). Functional and overall outcomes after extended right hepatectomy were evaluated. Patients without presurgical treatment served as controls (n = 18). RESULTS: In preconditioned patients, mean hepatic growth of segments II/III 14 days after PVE in the PVE+SC group was significantly higher (138.66 mL ± 66.29) when compared with that of PVE group patients (62.95 mL ± 40.03; P = 0.004). There were no significant differences among all 3 groups regarding general and oncological characteristics and functional parameters on postoperative day (POD) 7. Lack of hepatic preconditioning, extrahepatic extension of resection, and postoperative complications were of negative prognostic value, using univariate analysis (P < 0.05). In multivariate analysis, freedom from postoperative major complications (P = 0.012), coagulation status on POD 7 (international normalized ratio < 1.4; P = 0.027), and presurgical expansion of the future liver remnant volume (P = 0.048) were positively associated with overall survival. Post hoc analysis revealed a better survival for the PVE+SC group (P = 0.028) compared with the PVE group (P = 0.094) and compared with controls. CONCLUSION: Promising data from this survival analysis suggest that PVE, together with CD133+ BMSC pretreatment, could positively impact overall outcomes after extended right hepatectomy.
Authors: Boris Guiu; Patrick Chevallier; Alban Denys; Elisabeth Delhom; Marie-Ange Pierredon-Foulongne; Philippe Rouanet; Jean-Michel Fabre; François Quenet; Astrid Herrero; Fabrizio Panaro; Guillaume Baudin; Jeanne Ramos Journal: Eur Radiol Date: 2016-04-18 Impact factor: 5.315
Authors: Jan Schulte am Esch; Moritz Schmelzle; Constanze Duhme; Guenter Fuerst; Simon C Robson; Johannes G Bode; Andreas Krieg; Stefan A Topp; Dieter Haeussinger; Wolfram T Knoefel Journal: Ann Surg Date: 2016-03 Impact factor: 12.969
Authors: Moritz Schmelzle; Katrin Splith; Lars W Andersen; Miroslaw Kornek; Detlef Schuppan; Caitlin Jones-Bamman; Martina Nowak; Vasilis Toxavidis; Steven D Salhanick; Lihui Han; Jan Schulte am Esch; Sven Jonas; Michael W Donnino; Simon C Robson Journal: Transplantation Date: 2013-01-15 Impact factor: 4.939
Authors: Jan Schulte Am Esch; Simon C Robson; Moritz Schmelzle; Constanze Duhme; Wolfgang Junger; Steven D Salhanick; Yu Chen; Yan Wu; Vasilis Toxavidis; Eva Csizmadia; Lihui Han; Shu Bian; Günter Fürst; Martina Nowak; Seth J Karp; Wolfram T Knoefel Journal: Ann Surg Date: 2013-04 Impact factor: 12.969