Italian doctors have treated a boy suffering from a rare liver disease by infusing donor liver cells in a 3-hour operation that did not require anesthesia. The procedure could offer a new therapy for this and other liver conditions, they said.
Giovanni Ambrosino, MD and colleagues from the University of Padua's First Surgical Department performed the procedure October 11 on a 10-year-old Croatian boy with Crigler-Najjar disease. The mainstay of treatment for this inherited condition, in which the liver fails to produce an enzyme that allows bilirubin to be excreted by the body, is phototherapy-up to 16 hours daily. Liver transplantation can be effective, but the shortage of donor organs and the need for life-long immunosuppression posttransplant are limiting factors. "Our goal is to avoid a whole liver transplant," said Ambrosino. "Infusion of liver cells proved to be relatively easy to accomplish."
Approximately 7.5 ml of hepatic cells isolated from the left lobe of a donor liver were infused over a 3-hour period via a catheter inserted 2 weeks earlier under local anesthesia. "The first infusion lasted 1 hour, and it was followed by a 1-hour break," Ambrosino described. "Then we proceeded with the second infusion, which lasted another hour. During the entire operation, the boy watched TV and talked to his mother.
"This painless, safe technique, which doesn't require the use of an entire liver, can open new horizons in the treatment of this illness and other non-cirrhotic diseases," continued Ambrosino. "The next step will be the infusion of genetically modified hepatic cells." The next weeks will determine if the infused cells were able to increase the activity of the defective enzyme, he added.
In 1997, Transplant News reported the first attempt at donor hepatocyte infusion for the treatment of Crigler-Najjar. The 15-hour procedure, which required general anesthesia, was performed on a 10-year-old girl by Ira Fox, MD of the University of Nebraska Medical Center in Omaha.
Via: http://findarticles.com
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