The past two decades have witnessed an explosion of research and clinical application of stem cells, transforming the field of regenerative medicine. Stem cell transplantation has already been performed to treat patie...The past two decades have witnessed an explosion of research and clinical application of stem cells, transforming the field of regenerative medicine. Stem cell transplantation has already been performed to treat patients with cancer,liver diseases, and various types of chronic diseases. Indeed, stem cell-based therapies are effective in many diseases, and provide novel insights into the treatment of end-stage liver disease. Several clinical trials have indicated the efficacy profiles of stem cell transplantation in patients with end-stage liver disease, including liver cirrhosis, liver failure, and liver tumors. Animal models of acute liver failure have also provided important insights into the safety,mechanisms, and efficacy of stem cell therapies. Nevertheless, excitement due to this promising field must be tempered with careful and calculated research. In particular, studies on the quality, safety, and efficacy of stem cell transplantation are needed to ensure that qualified products are tested in well-designed clinical trials and approved by governments. Therefore, further investigations are required to effectively balance the safety with the innovation of stem cell transplantation research toward the effective treatment of end-stage liver disease.展开更多
Background and Aims:The association between portalsystemic shunt and hepatocellular carcinoma(HCC)development in patients who have cirrhosis is still controversial.This systematic review with meta-analysis was perform...Background and Aims:The association between portalsystemic shunt and hepatocellular carcinoma(HCC)development in patients who have cirrhosis is still controversial.This systematic review with meta-analysis was performed to systematically clarify the potential role of portal-systemic shunt in the development of HCC.Methods:The PubMed,Embase,and Cochrane Library databases were searched for potentially eligible literature.Meta-analysis with random-effects model was performed to combine the incidence rates of HCC after portal-systemic shunt.Finally,seven studies were included.In the present review,we mainly focused on 859 patients(365 in the transjugular intrahepatic portal-systemic shunt(TIPS)group and 494 in the non-TIPS group)from five studies to analyze incidence rates after TIPS.Results:At the end of follow-up,there were 66(18%,66/365)patients who developed HCC after TIPS intervention and 63(13%,63/494)patients who developed HCC after non-TIPS treatments.Pooled estimates with random-effects model did not demonstrate a significant increase of incidence of HCC after TIPS(risk ratio:1.37[confidence interval(CI):0.96 to 1.97];p=0.08)compared with non-TIPS treatments.Subgroup analyses for those patients with transplanted liver also did not detect a significant difference between the TIPS group and non-TIPS group(risk ratio:1.10[CI:0.59 to 2.07];p=0.75).Conclusions:Current evidence suggests that portal-systemic shunt is not associated with a higher risk of HCC development in cirrhotic patients.展开更多
文摘The past two decades have witnessed an explosion of research and clinical application of stem cells, transforming the field of regenerative medicine. Stem cell transplantation has already been performed to treat patients with cancer,liver diseases, and various types of chronic diseases. Indeed, stem cell-based therapies are effective in many diseases, and provide novel insights into the treatment of end-stage liver disease. Several clinical trials have indicated the efficacy profiles of stem cell transplantation in patients with end-stage liver disease, including liver cirrhosis, liver failure, and liver tumors. Animal models of acute liver failure have also provided important insights into the safety,mechanisms, and efficacy of stem cell therapies. Nevertheless, excitement due to this promising field must be tempered with careful and calculated research. In particular, studies on the quality, safety, and efficacy of stem cell transplantation are needed to ensure that qualified products are tested in well-designed clinical trials and approved by governments. Therefore, further investigations are required to effectively balance the safety with the innovation of stem cell transplantation research toward the effective treatment of end-stage liver disease.
文摘Background and Aims:The association between portalsystemic shunt and hepatocellular carcinoma(HCC)development in patients who have cirrhosis is still controversial.This systematic review with meta-analysis was performed to systematically clarify the potential role of portal-systemic shunt in the development of HCC.Methods:The PubMed,Embase,and Cochrane Library databases were searched for potentially eligible literature.Meta-analysis with random-effects model was performed to combine the incidence rates of HCC after portal-systemic shunt.Finally,seven studies were included.In the present review,we mainly focused on 859 patients(365 in the transjugular intrahepatic portal-systemic shunt(TIPS)group and 494 in the non-TIPS group)from five studies to analyze incidence rates after TIPS.Results:At the end of follow-up,there were 66(18%,66/365)patients who developed HCC after TIPS intervention and 63(13%,63/494)patients who developed HCC after non-TIPS treatments.Pooled estimates with random-effects model did not demonstrate a significant increase of incidence of HCC after TIPS(risk ratio:1.37[confidence interval(CI):0.96 to 1.97];p=0.08)compared with non-TIPS treatments.Subgroup analyses for those patients with transplanted liver also did not detect a significant difference between the TIPS group and non-TIPS group(risk ratio:1.10[CI:0.59 to 2.07];p=0.75).Conclusions:Current evidence suggests that portal-systemic shunt is not associated with a higher risk of HCC development in cirrhotic patients.
