Preliminary Study Of Multimodal Ultrasound Parameters In The Efficacy Of Stem Cell Therapy For Liver Cirrhosis

Purpose: To explore the therapeutic effect of umbilical cord mesenchymal stem cells(UC-MSCs)therapy in patients with hepatitis B decompensated cirrhosis from multiple aspects by comparing multimodal ultrasound parameters,biochemical indicators,serum liver fibrosis indicators,and liver biopsy results before and after UC-MSCs therapy,in order to find an effective method to evaluate the effect of stem cell therapy.To provide a more scientific and intuitive basis for the clinical application of stem cell transplantation in the treatment of chronic liver diseases.Methods: A total of 15 patients with hepatitis B decompensated cirrhosis who underwent ultrasound-guided infusion of UC-MSCs through portal vein catheterization in Sichuan Provincial People’s Hospital from November 2021 to December 2022 were enrolled.The portal vein diameter and portal vein blood flow velocity,the Young’s modulus of the liver,the quantitative parameters(Peak intensity,Time to peak,Mean transit time)of liver parenchyma and intrahepatic vessels on contrast-enhanced ultrasound(CEUS)were collected before transplantation,4 weeks after transplantation,12 weeks after transplantation,and 24 weeks after transplantation,combined with liver function,coagulation function,serum liver fibrosis indicators,and liver biopsy.The parameters before and after transplantation were compared,and the efficacy of UC-MSCs transplantation in patients with decompensated cirrhosis was analyzed from multiple angles.Results: UC-MSCs were successfully infused through portal vein in all 15 patients.The Young’s modulus of liver was significantly different before and 24 weeks after transplantation(10.36±1.52 k Pa VS 9.69±1.21 k Pa;P=0.03).There was no significant difference in portal vein diameter and portal vein blood flow velocity before transplantation,4 weeks after transplantation,12 weeks after transplantation and 24 weeks after transplantation(P > 0.05).The quantitative parameters(Peak intensity,Time to peak,Mean transit time)of CEUS in portal vein,liver parenchyma and hepatic vein before transplantation,4 weeks after transplantation,12 weeks after transplantation and 24 weeks after transplantation had no significant difference(P > 0.05).The difference of Prothrombin time between before transplantation and 12 weeks and 24 weeks after transplantation was statistically significant(13.02±1.45 s,12.67±0.99 s,12.53±1.13 s,P <0.05).There were significant differences in Hyaluronic acid and Ⅳ-Collagen before transplantation and 24 weeks after transplantation(295.84±95.09 ng/m L VS 259.15±85.16 ng/m L;148.59±22.22 ng/m L VS 130.94±35.80 ng/m L,P < 0.05).The scores of focal(spotty)lytic necrosis,apoptosis and focal inflammation were significantly different before and after transplantation(P<0.04).Conclusion: UC-MSCs therapy can improve coagulation function,reduce serum liver fibrosis indicators,and improve liver tissue inflammation and necrosis in patients with decompensated cirrhosis.At the same time,UC-MSC therapy has a certain effect on improving liver stiffness in patients with decompensated cirrhosis.However,in this study,no significant hemodynamic effect of UC-MSCs on end-stage cirrhosis was found within 24 weeks after transplantation.