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A Journal on Surgery

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Minerva Chirurgica 2013 April;68(2):163-8


language: English

Autologous CD133+ cells augment the effect of portal embolization

Canepa M. C. 1, Quaretti P. 2, Perotti C. 3, Vercelli A. 2, Rademacher J. 1, Peloso A. 1, Barbieri L. 1, Franchi E. 1, Briani L. 1, Gaspari A. 1, Brugnatelli S. 4, Pedrazzoli P. 4, Dionigi P. 1, Maestri M. 1

1 Department of General Surgery I IRCCS Policlinico San Matteo Pavia and University of Pavia, Pavia, Italy; 2 Department of Radiology IRCCS Policlinico San Matteo Pavia, Pavia, Italy; 3 Department of Immunohematology IRCCS Policlinico, San Matteo, Pavia, Italy; 4 Department of Oncology IRCCS Policlinico San Matteo Pavia, Pavia, Italy


Aim: The standard to treat liver tumors is a resection. When the future liver remnant (FLRV) is below 30% (healthy livers) or 40% (cirrhotic livers or previous chemotherapy), surgery carries the risk of severe complications. Portal vein embolization (PVE) gained a worldwide diffusion as a tool to augment the FLRV. Cell therapies are recent players at the frontiers of medicine. This study presents a clinical experience to evaluate the synergistic effect of combined PVE and autologous CD133+ cells coadministration.
Methods: Sixteen patients have been enrolled in the study up today. Inclusion criteria were: primary or metastatic liver malignancy with a FLRV<30% or 40%. A baseline volumetric CT-scan was obtained. CD34+ were mobilized to the blood stream by G-CSF administration and collected by immunomagnetic separation. Simultaneously with PVE, cells were administered to the non occluded liver segments. Follow-up CT scans were taken at 30th post treatment day.
Results: The patients (N.=6) showed an increased volume gain (Mann-Whitney test P<0.001, two sided) compared to a set of cases whose treatment was PVE only (N.=10).
Discussion: The use of autologous stem cells as an augmenter of liver regeneration has a clinical potential to improve the resectability of liver tumors.

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