AI Article Synopsis

  • Orthotopic liver transplantation (OLT) is the main treatment for end-stage liver disease, but post-transplant rejection remains a significant challenge.
  • The study tested the ability of bone marrow-derived liver stem cells (BDLSC) and mature hepatocytes to repopulate livers in a rat model experiencing rejection after OLT, using a specific transplantation method and minimal immunosuppression.
  • Results showed that BDLSC successfully repopulated a large percentage of the rejecting livers and even differentiated into liver cells, suggesting a promising approach for enhancing liver transplant outcomes.

Article Abstract

Background: The definitive therapy for end-stage liver disease is orthotopic liver transplantation (OLT). However, rejection is still a major cause of mortality and morbidity following OLT. Hepatocyte transplantation has been used experimentally to treat liver diseases. The aim of this study was to investigate whether bone marrow-derived liver stem cells (BDLSC) and mature hepatocytes could repopulate transplanted livers undergoing rejection.

Methods: OLT was carried out from D'Agouti (C3-positive female) into Lewis (C3-negative female) rats. BDLSC were transplanted from Lewis (male) into livers of D'Agouti (female) rats. Group A (n = 9) received intraportal normal saline. Groups B (n = 9) and C (n = 9) underwent intraportal transplantation of mature hepatocytes (Lewis female, 0.75 x 10(7)) and DBLSC (Lewis male, 5 x 10(4)) respectively. All groups received subtherapeutic immunosuppression (Cyclosporin 0.25 mg/kg/d) for 13 days. Liver repopulation was assessed using immunohistochemistry (C3 antigen-negative cells), in-situ hybridization, (Y-chromosome-positive BDLSC) and histologic assessment (hematoxylin and eosin) for rejection.

Results: BDLSC and mature hepatocytes repopulated 62 +/- 12.3% and 2.5 +/- 1.7% of rejecting livers, respectively. BDLSC demonstrated formation of hepatic lobules and portal triads with little evidence of rejection 36 days after discontinuation of immunosuppression.

Conclusions: BDLSC can repopulate livers undergoing severe rejection. Moreover, BDLSC can differentiate into hepatocytes and cholangiocytes. This finding may have important clinical implications.

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http://dx.doi.org/10.1067/msy.2002.125785DOI Listing

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