Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2017 Vol. 25 No 4

GENERAL & SPECIAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2017.4.350   |  

A.F. CHERNOUSOV, T.V. KHOROBRYKH, R.V. KARPOVA, K.I. ZENKOVA

EFFECT OF CRYOPRECIPITATE ON LIVER REGENERATION IN PATIENTS WITH CIRRHOSIS

FSBEE HE I. M. Sechenov First Moscow State Medical University, Moscow,
The Russian Federation

Objectives. To improve the results of treating patients with liver cirrhosis by intrahepatic injection of cryoprecipitate, stimulating regeneration of cirrhotic liver.
Methods. The study included 72 patients who suffered from hepatitis B virus (HBV) and hepatitis C virus (HCV) and toxic liver cirrhosis. 32 (44%) patients had liver cirrhosis grading Child-Pugh class B, and 40 (56%) patients class C. Cryoprecipitate injected percutaneously into the liver by puncture method under ultrasound guidance. Dynamics of clinical and laboratory parameters, portal blood flow in all patients, morphological changes in the liver biopsy were evaluated in 42 (58%) patients and immunological parameters in 38 (53%) patients before and after administration of cryoprecipitate.
Results. The improvements of clinical and laboratory parameters were registered in 3, 6, and 12 months after the administration of cryoprecipitate in most patients. After a year 7 patients had liver cirrhosis grading Child-Pugh class C (out of 40 patients). Diameters of the portal and splenic vein significantly decreased in 65 (90%) patients in a year, the congestion index decreased in 11 patients (15%), splenoportal index in 18 (25%). During the morphological study of the liver biopsy 1 year afterward, a positive dynamics observed by a decrease in cellular infiltration and inflammatory signs so as signs of regeneration were found in 40 (95%) out of 42 patients and decrease of the severity of the stepped necrosis of hepatocytes was registered in 29 (69%) patients.
Conclusion. Cryoprecipitate injected percutaneously under ultrasound guidance is considered to be safe due to its potential to avoid damage of large liver vessels. The stimulatory effect of cryoprecipitate on liver regeneration was studied so as it improves its functional activity and extends terms prior liver transplantation.

Keywords: liver cirrhosis, portal hypertension, surgical treatment, liver regeneration, minimally invasive surgery, cryoprecipitate, functional activity
p. 350-358 of the original issue
References
  1. Uryvaeva IV. Stvolovye kletki pecheni v regeneracii pecheni. V kn: Pal'cev MA, red. Biologija stvolovyh kletok i kletochnye tehnologii [Biology of stem cells and cellular technology]. Moscow, RF; 2009. p. 211-52.
  2. Sherlok Sh, Duli Dzh. Zabolevanija pecheni i zhelchnyh putej [Diseases of the liver and biliary tract:]: prakt ruk: per s angl. Moscow, RF: GJeOTAR-Med; 2002. 864 p.
  3. Chernousov AF, Horobryh TV, Pastuhov DV. Vlijanie fibrinovogo kleja na hod posttravmaticheskoj regeneracii pecheni [Effect of fibrin glue on the course of post-traumatic liver regeneration]. Annaly Hirurg Gepatologii. 2006;11(3):61.
  4. Chernousov AF, Horobryh TV, Karpova RV, Nekrasova TP. Regeneracija cirroticheski izmenennoj pecheni krolikov pri vnutripechenochnom vvedenii krioprecipitata [Regeneration of cirrhotically altered liver of rabbits with intrahepatic administration of cryoprecipitate]. Bjul Jeksperim Biologii i Mediciny. 2012;154(9):384-86.
  5. Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, Kiernan TW, Wollman J. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology. 1981 Sep-Oct;1(5):431-5.
  6. Burganova GR. Ocenka jeffektivnosti transplantacii autologichnyh gemopojeticheskih stvolovyh kletok u bol'nyh cirrozom pecheni [Evaluation of the efficiency of autologous hematopoietic stem cell transplantation in patients with liver cirrhosis]. Jeksperim i Klin Gastrojenterologija. 2012;(4):91-97.
  7. Manuk'jan GV, Eramishancev AK, Suhih GT, Markarjan ASh, Musin RA, Ambarcumjan LR, i dr. Vnutriorgannaja allotransplantacija stvolovyh i progenitornyh kletok pri lechenii bol'nyh cirrozom pecheni i portal'noj gipertenziej [Intra-organ allotransplantation of stem and progenitor cells in the treatment of patients with cirrhosis and portal hypertension]. Annaly Hirurg Gepatologii. 2007;12(2):31-37.
  8. Mogilevec JeV, Gorelik PV, Batvinkov NI. Metody stimuljacii regeneracii pri cirroze pecheni [Methods of stimulation of regeneration in liver cirrhosis]. Novosti Hirurgii. 2013;21(3):103-109. doi: 10.18484/2305-0047.2013.3.103.
  9. Nartajlakov MA, Muldashev JeR, Mingazov RS, Muslimov SA, Safin IA, Musina LA, i dr. Hirurgicheskoe lechenie hronicheskogo gepatita i cirroza pecheni [Surgical treatment of chronic hepatitis and cirrhosis of the liver]. Annaly Hirurg Gepatologii. 2005;10(2):13-20.
  10. Lyra AC, Soares MB, da Silva LF, Braga EL, Oliveira SA, Fortes MF, et al. Infusion of autologous bone marrow mononuclear cells through hepatic artery results in a short-term improvement of liver function in patients with chronic liver disease: a pilot randomized controlled study. Eur J Gastroenterol Hepatol. 2010 Jan;22(1):33-42. doi: 10.1097/MEG.0b013e32832eb69a.
  11. Terai S, Takami T, Yamamoto N, Fujisawa K, Ishikawa T, Urata Y, et al. Status and prospects of liver cirrhosis treatment by using bone marrow-derived cells and mesenchymal cells. Tissue Eng Part B Rev. 2014 Jun;20(3):206-10. doi: 10.1089/ten.TEB.2013.0527.
Address for correspondence:
119991, Russian Federation, Moscow,
B. Pirogovskaya str. 6/1
University Clinical Hospital N1,
Department of Faculty Surgery N1
Tel .: +7 499 248 76 10,
E-mail: radmila.71@mail.ru,
Radmila V. Karpova
Information about the authors:
Chernousov A.F. Academician of RAMS, MD, Professor, Head of department of faculty surgery N1 of the medical faculty, FSBEE HE I.M.Sechenov First Moscow State Medical University.
Khorobrykh T.V. Professor of department of faculty surgery N1 of the medical faculty, FSBEE HE I.M.Sechenov First Moscow State Medical University.
Karpova R.V. MD, Professor of department of faculty surgery N1 of the medical faculty, FSBEE HE I.M.Sechenov First Moscow State Medical University.
Zenkova K.I. A 5-year student of the medical faculty, FSBEE HE I.M.Sechenov First Moscow State Medical University.
Contacts | ©Vitebsk State Medical University, 2007