Monitoring of intraportal liver cell application in children

Despite recent advances and promising results in children, liver cell transplantation (LCT) should still be regarded as an experimental therapy. Several substantial complications are known from animal studies and individual patients. However, safety data on liver cell infusion in children are scarce...

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Main Authors: Meyburg, Jochen (Author) , Hörster, Friederike (Author) , Schmidt, Jan (Author) , Pöschl, Johannes (Author) , Hoffmann, Georg F. (Author) , Schenk, Jens-Peter (Author)
Format: Article (Journal)
Language:English
Published: May 1, 2010
In: Cell transplantation
Year: 2010, Volume: 19, Issue: 5, Pages: 629-638
ISSN:1555-3892
DOI:10.3727/096368909X485058
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3727/096368909X485058
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Author Notes:Jochen Meyburg, M.D., Friederike Hoerster, Jan Schmidt, Johannes Poeschl, Georg F. Hoffmann, and Jens-Peter Schenk
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Summary:Despite recent advances and promising results in children, liver cell transplantation (LCT) should still be regarded as an experimental therapy. Several substantial complications are known from animal studies and individual patients. However, safety data on liver cell infusion in children are scarce. We used LCT in four children of different ages (3 weeks to 11 years, 3?40 kg) and underlying diseases [acute liver failure (n = 1), urea cycle disorders (n = 2), and Crigler-Najjar syndrome (n = 1)]. Vital parameters, portal vein flow (PVF), portal vein pressure (PVP), and liver enzymes were measured every 5 min during cell application and hourly thereafter between applications. An application protocol with discontinuation rules depending on changes in PVF and PVP was developed and successfully applied. Application was feasible in all children despite the catastrophic overall condition of the patient with acute liver failure. No application-related changes in vital parameters were found, and none of the children experienced clinical signs of portal vein thrombosis, pulmonary embolism, or anaphylactic reactions. Time courses for changes in PVF, PVP, and liver enzymes were obtained. Thorough monitoring of portal vein pressure and duplex sonography according to a defined protocol is likely to increase safety of cell application in pediatric LCT.
Item Description:Gesehen am 20.04.2023
Physical Description:Online Resource
ISSN:1555-3892
DOI:10.3727/096368909X485058