Objective The purpose of this study was to test the safety and efficacy of mesenchymal stromal cells (MSCs) treatment with a simplified protocol for ABO incompatible (ABO-I) liver transplantation (LT) in severe hepatic failure patients. Methods 18 patients with severe hepatic failure received ABO-I LT in our hospital were recruited in this phase I, prospective, single center clinical study, from January 2014 to September 2016. A simplified protocol, including plasma exchange, rituximab, intravenous immunoglobin and MSCs, without splenectomy and graft local infusion, was used to prevent antibody-mediated rejection (AMR). The standard immunosuppressive protocol consisted of basiliximab, steroids, tacrolimus and mycophenolate mofetil. Results At a mean follow-up of 15.2 months (range, 2 days-26 months), 3 patients died due to multi-organ septic failure (2 patients) and gastrointestinal hemorrhage (1 patient). The major complications were infection (n=10, 55.6%) and biliary complications (n=5, 27.8%). No patients developed AMR after ABO-I LT. Also, no MSCs related adverse events (include fever, allergic reaction and malignancies) were observed during the follow-up period. Conclusion This new therapeutic protocol with the clinical translation of MSCs seems safe and effective for adult ABO-I LT in severe hepatic failure patients.

CITATION INFORMATION: Zhang Y., Zheng J., Cai J., Zhang J., Zeng K., Yao J., Yang Y. Clinical Application of Mesenchymal Stromal Cells with a Simplified Protocol for ABO Incompatible Liver Transplantation in Severe Hepatic Failure Patients Am J Transplant. 2017;17 (suppl 3).

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