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©2013 UpToDate ® Print Email Transplantation of allogeneic hepatocyte in 37 patients with acute liver failure Diagnosis, [reference] Age Procedure and Outcome Acetaminophen [1] 16 years Intraportal (4x10 7 cells), NH 3 ↓, encephalopathy grade 4 unchanged. Died on d2. [7] 26 years Intrasplenic (1.2x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved, d2 OLT, full recovery. INH [1] 12 years Intraportal (1x10 8 cells x 3). NH 3 ↓, encephalopathy grade 4 unchanged. Died on d7. Phenytoin [1] 10 years Intraportal (2.8x10 9 cells x 3), NH 3 ↓, encephalopathy grade 4 unchanged. Died of viral meningitis on d7. Dilantin [2] 13 years Intraportal (1x10 9 cells). encephalopathy grade 4 unchanged. Died on d4. [7] 27 years Intrasplenic (2.8x10 7 ), NH 3 ↓ and encephalopathy grade 4 improved, d10 OLT, full recovery. Tegretol [3] 14.8 years Intraportal (2.5x10 9 cells). NH 3 ↓, encephalopathy grade 4 improved. OLT on d1. Full recovery, 6 year follow-up. Idiopathic [1] 3 years Intraportal (4x10 9 cells x 9 infusions). NH 3 ↓ and encephalopathy improved. Full recovery. [1] 5 years Intraportal (2x10 9 cells x 7 infusions). NH 3 ↓ and encephalopathy grade 4 improved. OLT on d4. Full recovery. [4] 3.5 months Intraportal (1.8x10 8 cells). Encephalopathy unchanged. OLT on d1. Full recovery. [5] 8 years Intraperitoneal (6x10 7 fetal liver cells/kg bw). Encephalopathy grade 3 improved, full recovery. Viral [3] 4 years Intraportal (1.7x10 9 cells x 2). NH 3 ↓, encephalopathy grade 3 improved. Intracranial hemorrhage on d2. Halothane [2] 43 years Encephalopathy grade 4 improved. Died on day 35 from sepsis. Polysubstance Abuse [6] 32 years Intrasplenic (1.3x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved to grade 2. Died on d14 from sepsis. [6] 35 years Intrasplenic (1x10 10 cells), NH 3 ↓ and encephalopathy grade 4 improved. Died on d20 from sepsis. [3] 21 years Intrasplenic (9x10 8 cells x 2 and 2.5x10 7 x 1), encephalopathy grade 4 unchanged, d1 brain death. [3] 35 years S/P OLT, intraportal (5.4x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved. Died on d18 from sepsis. [3] 35 years Intraportal, (3.7x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved, full recovery with more than 1 year follow up. [3] 51 years Intraportal (3.9x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved, died of mesenteric thrombosis on d3. [6] 32 years Intraperitoneal (6x10 7 fetal hep./kg), encephalopathy grade 4 unchanged. Died after 30 hours. [6] 29 years

Intraportal, (3.7x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved, full recovery with more than 1 year follow up. [3] 51 years Intraportal (3.9x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved, died of mesenteric thrombosis on d3. [6] 32 years Intraperitoneal (6x10 7 fetal hep./kg), encephalopathy grade 4 unchanged. Died after 30 hours. [6] 29 years Intraperitoneal (6x10 7 fetal hep/kg), encephalopathy grade 4 unchanged. Died after 37 hours. [6] 20 years Intraperitoneal (6x10 7 fetal hep/kg), encephalopathy grade 4 unchanged, Died after 48 hours. [6] 20 years Intraperitoneal (6x10 7 fetal hep/kg, encephalopathy grade 4 improved, full recovery. [6] 24 years Intraperitoneal (6x10 7 fetal hep/kg), encephalopathy grade 3 improved, full recovery. Chloroform, EtOH [6] 55 years Intrasplenic (3.9x10 10 cells), encephalopathy grade 4 unchanged, multisystem organ failure 6 hours. Etiology unknown [8] 23 years Intrasplenic, (2.86x10 8 and 1.52x10 8 cells), NH 3 ↓, and encephalopathy grade 3 improved, OLT on d5, multisystem organ failure on d13. Reyes syndrome [3] 48 years Intraportal, (7.5x10 8 cells), NH 3 ↓, encephalopathy grade 4 unchanged, brain death on d1. <i>Amanita phalloides</i> [8] 64 years Intraportal, (4.9x10 9 cells), NH 3 ↓ and encephalopathy grade 4 improved, full recovery, off immuno 12 weeks. Post-surgical trisegmentectomy [2] 69 years Intrasplenic, (3.6x10 8 cells and 1.7x10 8 cells), encephalopathy grade 4 unchanged, died on day 2. Herpes II [6] 29 years Intraportal + intrasplenic (1x10 10 cells), encephalopathy grade 4 unchanged, O2 ↓. Died after 18 hours. [4] 37 years Intrasplenic, (1.2x10 8 cells), NH 3 ↓ and encephalopathy grade 4 improved. Died on d5 from sepsis. HBV [6] 65 years Intraportal + intrasplenic, (3x10 10 cells), encephalopathy grade 3 improved, NH 3 ↓ & O 2 ↓, multisystem organ failure on d52. [2] 28 years Intrasplenic, (1.69x10 8 cells), NH 3 ↓ and encephalopathy grade 4 improved, OLT d3, full recovery. [2] 43 years Intraportally, (2.43x10 8 cells x 3 ), encephalopathy 4, OLT on d1, full recovery. [5] 40 years Intraperitoneal, (6x10 7 cells/kg body weight), encephalopathy grade 4 unchanged. Died after 13 hours. HBV + cocaine [9] 37 years Intrasplenic, (8.8x10 8 cells), NH 3 ↓ and encephalopathy grade 2 improved, full recovery with 7 year follow up. HBV + lymphoma [3] 54 years Intraportal, (6.6x10 9 cells), NH 3 ↓ and encephalopathy grade 2 improved, multisystem organ death d7.

Intraperitoneal, (6x10 7 cells/kg body weight), encephalopathy grade 4 unchanged. Died after 13 hours. HBV + cocaine [9] 37 years Intrasplenic, (8.8x10 8 cells), NH 3 ↓ and encephalopathy grade 2 improved, full recovery with 7 year follow up. HBV + lymphoma [3] 54 years Intraportal, (6.6x10 9 cells), NH 3 ↓ and encephalopathy grade 2 improved, multisystem organ death d7. 1. Soriano HE, Wood RP, Kang DC, et al. Hepatocellular transplantation HCT) in children with fulminant liver failure. Hepatology 1997; 30:239A. 2. Strom SC, Roy-Chowdhury J, Fox IJ. Hepatocyte transplantation for the treatment of human disease. Semin Liver Dis 1999; 19:39. 3. Fisher RA, Strom SC. Human hepatocyte Transplantation: Worldwide results. Transplantation 2006; 82:441. 4. Sterling RK, Fisher RA. Liver Transplantation: Living Donor, Hepatocyte, and Xenotransplantation. In: Current Future Treatment Therapies for Liver Disease. Clinics in Liver Disease. Gish R, ed. Philadelphia: WB Saunders, 2001. 5. Habibullah CM, Syed IH, Qamar A, Taher-Uz Z. Human fetal hepatocyte transplantation in patients with fulminant hepatic failure. Transplantation 1994; 58:951. 6. Bilir BM, Guinette D, Karrer F, et al. Hepatocyte transplantation in acute liver failure. Liver Transp 2000; 6:32. 7. Fisher RA, Strom SC. Human Hepatocyte Transplantation: Biology and Therapy. In the Hepatocyte Review. Berry MN, Edwards AM, eds. Dordrecht, The Netherlands: Kluwer Academic Publishers, 2000. 8. Ott M, Barthold M, Alexandrova K, et al. Clinical applications of human hepatocytes isolated under CGMP conditions. 40th annual meeting of the European Association for the study of the liver. 2005: Ab 716. 9. Fisher RA, Bu D, Thompson M, et al. Defining hepatocellular chimerism of a liver failure patient bridged with hepatocyte infusion. Transplantation 2000; 69:303.