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Pediatric Surgery International

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01-01-2011 | Original Article

Bone marrow mononuclear stem cell infusion improves biochemical parameters and scintigraphy in infants with biliary atresia

Authors: Shilpa Sharma, Lalit Kumar, Sujata Mohanty, Rakesh Kumar, S. Datta Gupta, Devendra K. Gupta

Published in: Pediatric Surgery International | Issue 1/2011

Abstract

Purpose

To evaluate early postoperative results in a case controlled study following clinical use of stem cells in extrahepatic biliary atresia (EHBA).

Methods

From July 2005 to March 2008, 30 cases of suspected EHBA were divided in two groups in an intervention study. Group A received autologous mononuclear bone marrow stem cells at the time of Kasai or after Kasai. In Group B, only Kasai was performed. Liver function tests on postoperative day 7 were compared. Serum bilirubin, clinical status, hepatic scintigraphy and survival at 6 months and 1 year were compared.

Results

Mean age was 136 (74–275) days in Group A and 99.7 (56–172) days in Group B. Preoperative values of serum bilirubin (SB), aspartate aminotransferase (AST), alanine aminotransferase and alkaline phosphatase (ALP) were comparable between the groups though there was significant difference in postoperative SB, AST and ALP (p = 0.014, 0.0041, 0.0005), with and without the use of stem cells. The median post stem cell SB was 6.9 (0.5–11.6) mg/dl in Group A versus 10.1 (5.6–26.3) mg/dl in Group B. Median SB at 6 months follow-up was 0.6 (0.5–5.4) mg/dl in Group A versus 7.6 (0.8–9.2) mg/dl in Group B (p = 0.028). There was a significant difference in episodes of cholangitis at 6 months postoperatively between the two groups (p = 0.024). Hepatic scans done at <3 months; >3 months follow-up showed prompt excretion in 80% (4/5); 85.7% (6/7) in Group A versus 20% (1/5); 50% (1/2) in Group B. Survival at 6; 12 months’ follow-up was 45.5%; 27.3% in Group A versus 33.3%; 6.7% in Group B. Median postoperative survival was 181 (139,223) days in Group A versus 123 (65,181) days in Group B.

Conclusion

Significant biochemical and scintigraphic improvement was noted following stem cell therapy in biliary atresia, probably attributable to anti-inflammatory action of stem cells.

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Title: Bone marrow mononuclear stem cell infusion improves biochemical parameters and scintigraphy in infants with biliary atresia
Authors: Shilpa Sharma
Lalit Kumar
Sujata Mohanty
Rakesh Kumar
S. Datta Gupta
Devendra K. Gupta
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: Pediatric Surgery International / Issue 1/2011
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-010-2712-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bone marrow mononuclear stem cell infusion improves biochemical parameters and scintigraphy in infants with biliary atresia

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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