J Korean Med Sci.  2015 Oct;30(10):1405-1415. 10.3346/jkms.2015.30.10.1405.

Therapeutic Effects of Mesenchymal Stem Cells for Patients with Chronic Liver Diseases: Systematic Review and Meta-analysis

• Kim G
• Eom YW
• Baik SK
• Shin Y
• Lim YL
• Kim MY
• Kwon SO
• Chang SJ

• KMID: 2344172
• DOI: http://doi.org/10.3346/jkms.2015.30.10.1405

Abstract

Based on their ability to differentiate into multiple cell types including hepatocytes, the transplantation of mesenchymal stem cells (MSCs) has been suggested as an effective therapy for chronic liver diseases. The aim of this study was to evaluate the safety, efficacy and therapeutic effects of MSCs in patients with chronic liver disease through a literature-based examination. We performed a systematic review (SR) and meta-analysis (MA) of the literature using the Ovid-MEDLINE, EMBASE and Cochrane Library databases (up to November 2014) to identify clinical studies in which patients with liver diseases were treated with MSC therapy. Of the 568 studies identified by the initial literature search, we analyzed 14 studies and 448 patients based on our selection criteria. None of the studies reported the occurrence of statistically significant adverse events, side effects or complications. The majority of the analyzed studies showed improvements in liver function, ascites and encephalopathy. In particular, an MA showed that MSC therapy improved the total bilirubin level, the serum albumin level and the Model for End-stage Liver Disease (MELD) score after MSC treatment. Based on these results, MSC transplantation is considered to be safe for the treatment of chronic liver disease. However, although MSCs are potential therapeutic agents that may improve liver function, in order to obtain meaningful insights into their clinical efficacy, further robust clinical studies must be conducted to evaluate the clinical outcomes, such as histological improvement, increased survival and reduced liver-related complications, in patients with chronic liver disease.

Keyword

Mesenchymal Stem Cells; Chronic Liver Diseases; Systematic Review; Meta-analysis

MeSH Terms

Cell Differentiation/physiology
Cell- and Tissue-Based Therapy/adverse effects/*methods
Hepatocytes/cytology
Humans
Liver/physiopathology/surgery
Liver Diseases/*therapy
Liver Function Tests
Mesenchymal Stem Cell Transplantation/adverse effects/*methods
Mesenchymal Stromal Cells/*cytology

Figure

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  Fig. 1 Flow chart of the study selection.

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  Fig. 2 Risk of bias. Summary of risk of bias for 14 selected studies.

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  Fig. 3 Forest plots. The effects of MSC treatment on total bilirubin (A) and serum albumin (B) were estimated after 6 months of treatment. SD, standard deviation; N, number of patients; CI, confidence interval; E, experimental; C, control; IV, inverse variance.

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