Accelerating effect of autologous bone marrow mesenchymal stem cells for restoration of liver function in a patient with acute liver failure induced by dimethylformamide

Objective To investigate the efficacy and safety of autologous bone marrow mesenchymal stem cells (BM-MSCs) in a patient with delayed liver function recovery after acute liver failure caused by dimethylformamide (DMF). Methods The liver function continued to be restored in a patient with acute liver failure induced by DMF after treated with artificial liver support system based comprehensive therapy, BM-MSCs were prepared and cultured in vitro, and then infused into the liver via the hepatic artery. The clinical manifestations, biochemistries, coagulation function, liver imaging, liver histopathology of the patient were observed as well as recent adverse events and long-term safety after transplantation. Results After the treatment of BM-MSCs, no significant adverse events were observed, unchanged liver function indexes improved, the recovery of coagulation function was accelerated, the prothrombin activity (PTA) gradually increased to more than 40%, Child-Pugh classification improved from grade A to grade B and score of Model for end-stage liver disease decrease from 21 to 7. The abdominal CT showed that the liver regeneration nodules increased at 4 weeks post-transplant. Liver cell degeneration, necrosis, fibrosis, cholestasis and regeneration co-existed in regenerative nodules as shown by a liver biosy. In the 3-year follow-up, the patient remained normal liver function. Neither significant changes in liver cirrhosis nodules nor ocurrence of cancer was observed. Conclusion BM-MSCs can promote the restoration of liver function in patient with delayed liver function recovery after acute liver failure caused by DMF. Transplantation of BM-MSCs into the liver via the hepatic artery results in mild adverse events. Key words: Bone marrow mesenchymal stem cells; Liver failure; Dimethylformamide; Efficacy; Safety