Source: Stem Cells and Genetic Sciences

In China, heart, lung, liver and kidney constitute the four major types of organ transplantation, of which liver transplantation accounts for up to 30 to 35 percent. Thanks to the development of medical technology in our country, liver transplantation has made remarkable achievements. As an effective treatment for end-stage liver disease, about 6,000 patients in China undergo this surgery every year. Although donor liver shortage remains a major constraint for liver transplantation, it is also important to improve the quality of life of those lucky enough to receive a transplant.

In recent years, mesenchymal stem cells (MSC) and their derivatives have shown great therapeutic potential in the field of organ transplantation. MSC is a kind of stem cells with self-renewal and differentiation potential, derived from bone marrow, fat, umbilical cord and other tissues, and has been proven to have significant effects in the treatment of liver diseases. Especially in the field of liver transplantation, MSC and its derivatives promote liver repair and regeneration through multiple mechanisms, reduce ischemia-reperfusion injury (IRI), and help improve donor liver quality.

1. Improves liver steatosis

With the increase of obesity rate, steatosis of donor liver has become a major problem in liver transplantation. By regulating the expression of miRNA, MSC and its derivatives can effectively inhibit the production of inflammatory factors and improve the disorder of lipid metabolism, thereby slowing down the progression of non-alcoholic fatty liver disease (NAFLD), providing a new possibility for the use of steatosis as a liver donor.

2. Repair ischemia-reperfusion injury

IRI is a major risk factor for early acute rejection after organ transplantation. MSC and its derivatives show significant advantages in reducing graft IRI, promoting cytokine expression and regulating signaling pathways, reducing inflammatory response and apoptosis, and accelerating organ repair and functional recovery.

3. Promote small volume donor liver regeneration

In split liver transplantation (SLT), the application of MSC is essential to improve the survival rate of small donor liver. By secreting cytokines, MSC promotes cell proliferation and angiogenesis, thereby accelerating liver regeneration and improving the success rate after SLT.

4. Feasibility and safety of donor liver repair

The application of MSC and its derivatives in donor liver repair shows high feasibility and safety. Especially in low temperature and hypoxia environment, MSC can maintain activity and biological function, promote liver regeneration, and reduce oxidative stress response. Summary: MSC and its derivatives show great therapeutic potential in perioperative liver transplantation and donor liver repair, not only expanding the donor pool, but also improving postoperative survival and long-term prognosis. With the continuous advancement of technology, the application of MSC in the field of liver transplantation will become the focus of future medical research.

References: Wang Yiting, Jiang Jie, Ma Li, et al. Potential value of mesenchymal stem cells and their derivatives in donor liver repair [J]. Journal of Organ Transplantation, 2023, 14(4): 592-597. (in Chinese) doi: 10.3969/j.issn.1674-7445.2023.04.017