| Objective: Long term immune suppression therapy for transplant recipients can significantly increase the incidence of infectious diseases and malignant tumors,immunosuppressive agents cannot prevent or delay the occurrence of chronic graft rejection.In recent years,many literatures have been reported that mesenchymal stem cells(MSC)played important roles in immune regulation and production of stable immune tolerance,which is conducive to reduce the incidence of graft rejection.In this experiment,comparing immune indicators of patients with joint huc-MSC treatment after liver transplantation and the patients only accepted conventional immunosuppressive therapy for liver transplantation,adverse event incidence rate,incidence of complications and comparisons of the liver function after transplantation to evaluate the safety and feasibility of clinical application of huc-MSC.Methods: From July 2014 to November 2015 in the liver transplantation center of the81 Hospital of PLA,the implementation of orthotopic liver transplantation in 40 cases of patients with 1:1 were randomly divided into groups according to the proportion of time in the experimental group and the control group,no significant difference between the two groups in age,gender.Randomly stratified by the following: Child-Pugh A/B/C classification before transplantation.The experimental group in the process of liver transplantation surgery and postoperative day 3 give huc-MSC by intravenous infusion,,dose was about 1*106/kg(Preparation of cell suspension into 50 ml),at the same time using standard protocols.Patients in the control group were treated with standard immunosuppression.Each patient will be followed up for more than 12 months.The assessment time points: before operation;third days after operation;seventh days after operation;first months after operation;second months after operation;third months after operation;sixth months after operation;twelfth months after operation;the assessment items in each time point involve blood biochemical;immune function;the incidence rate of acute and chronic rejection;the incidence of infection;the incidence of transplant related complications(hepatic artery and portal vein complications,biliary complications).In the event of acute and chronic rejection,patients do not need to wait for the visit time node,must immediately go to the hospital,and withdraw from the study.This experiment uses SPSS 19 statistical software to complete.The measurement data to mean±standard deviation(x±s)said that two groups of continuous variables were compared using Wilcoxon test,count data usingc 2 test or Fisher exact test,P<0.05 believes that the difference was statistically significant.Results: Compared with the control group,the peripheral blood of experimental group CD4 + CD25 +(regulatory T cells)was higher than that of the control group at third day and seventh day after surgery,CD4+(helper / inducer T cells)ratio and the content of CD4 + /CD8 + T lymphocytes the lower than the control group,the difference was statistically significant(P < 0.05),there was no significant difference of alanine aminotransferase and total bilirubin after operation(P > 0.05),the experimental group postoperative liver function abnormal events was significantly lower than the control group,the difference was statistically significant(P < 0.05),the incidence rate of two group the transplant related complications of infection rate showed no significant difference(P > 0.05).Conclusions: Intravenous infusion of huc-MSC after liver transplantation is safe and feasible;in early stage can promote the proliferation and activation of CD4 + CD25 + (regulatory T cells),reducing CD4+(helper / inducer T cells)ratio and the content of CD4 + /CD8 + T cells,and improve immune status in liver transplant recipients.this may be one way for human umbilical cord mesenchymal stem cells exerting their immunosuppressive function. |
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