Small-scale clinical studies have suggested that infusions of haematopoietic stem cells can reduce hepatic fibrosis and accelerate liver regeneration. However, in a multicentre, randomized controlled trial for patients with compensated chronic liver disease, no improvement in liver function and fibrosis was found for patients receiving autologous stem cell therapy compared with standard care. In the REALISTIC trial, patients were randomly assigned to a standard care group (n = 27) or groups receiving granulocyte colony-stimulating factor (G-CSF) with (n = 28) or without (n = 26) repeated infusions of autologous haematopoietic stem cells. No differences in MELD score were seen between the three groups after 90 days. Furthermore, serious adverse events (such as ascites, sepsis and encephalopathy) were more frequent in the G-CSF plus stem cell infusion group than in the G-CSF alone or standard care groups.
Newsome, P. N. et al. Granulocyte colony-stimulating factor and autologous CD133-positive stem-cell therapy in liver cirrhosis (REALISTIC): an open-label, randomised, controlled phase 2 trial. Lancet Gastroenterol. Hepatol. http://dx.doi.org/10.1016/S2468-1253(17)30326-6 (2017)
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Dickson, I. Stem cell therapy for liver cirrhosis unREALISTIC?. Nat Rev Gastroenterol Hepatol 15, 4 (2018). https://doi.org/10.1038/nrgastro.2017.178