Stem cell therapy has been found useful in over 60 per cent of the
patients due for liver transplant, as per a paper submitted by doctors
at Sir Ganga Ram Hospital in Delhi recently. Not only is the treatment
less cumbersome and risky, its cost is also comparatively very
reasonable.
According to the paper’s principal author and chairman of the Department
of Gastroenterology and Liver Diseases at the Hospital, Dr. Anil Arora,
a large number of patients requiring liver transplantation cannot
afford it for two reasons – cost and donor availability.
“A living donor is needed in such plantation cases with a matching blood
group and he or she also has to be a family member or a first or second
degree relative. They have to donate the liver. Since Rs.20 lakh is the
average cost of liver transplantation, a majority of liver cirrhosis
patients can not afford it. Many times they also do not have a donor,”
he said.
In view of the logistical problems faced by such patients, Dr. Arora
said: “We started looking at the feasibility of alternative methods like
using reserve cells in the body called stem cells for such treatment as
it costs even less than Rs.50,000. Some of these cells can be mobilised
from the bone marrow as it has the capacity to regenerate the cells. So
we stimulate the bone marrow by an injection.”
“This injection is given for five days and it mobilises the bone marrow
and some of the cells. They then come into the blood circulation. In the
study we tried to filter these cells from the blood marrow using a
specialised filtering machine and the concentrate of these cells. About 5
ml to 10 ml of the blood containing these concentrated group of cells
was then injected into the hepatic artery, which supplies blood to the
liver,” explained Dr. Arora. He said this process was carried out by a
number of different mechanisms and it proved quite successful. “We
started about two years ago and finished last year. Then these patients
were followed up for another one year and we were happy to see a
significant proportion of the patients having substantial improvement in
the liver functions as assessed by a score called ‘Child score’.”
Dr. Arora said, “All patients tolerated the treatment well without any
side effects. Of the 10 patients, six to seven benefited. So we believe
that more frequent administration of the stem cells in large number
might have a more beneficial impact.”
While the study by the Sir Ganga Ram Hospital team was published this
year and was approved by the Department of Biotechnology and Ministry of
Science and Technology, Government of India, Dr. Arora said there is
also other published data now which calls for “stimulating the bone
marrow and letting the cells automatically go into the liver”. By this,
he said, you avoid filtering and putting the blood with the stem cells
into the liver. “This is also equally beneficial.”
Dr. Arora said stem cell therapy “might act as a bridge for liver
transplant” and can provide some time to the patients to arrange for
treatment. But just like a damaged car tyre, he said, a damaged liver
after minor repairs has to be replaced. “However, if a person stops
taking liquor or if the therapy goes on well, then a patient can lead a
healthy life for many more years.”
Keywords: Stem cell therapy, liver transplantation, Sir Ganga Ram Hospital
