Retrospective Cohort Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Oct 26, 2018; 10(10): 138-145
Published online Oct 26, 2018. doi: 10.4252/wjsc.v10.i10.138
Efficacy and safety of autologous stem cell transplantation for decompensated liver cirrhosis: A retrospective cohort study
Ming-Fang Wang, You-Bing Li, Xiao-Juan Gao, Hao-Yang Zhang, Su Lin, Yue-Yong Zhu
Ming-Fang Wang, You-Bing Li, Su Lin, Yue-Yong Zhu, Liver Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
Xiao-Juan Gao, Fujian Provincial Governmental Hospital, Fuzhou 350001, Fujian Province, China
Hao-Yang Zhang, School of Biological Sciences, the University of Hong Kong, Hong Kong, China
Author contributions: Zhu YY and Lin S designed and conceived the study; Wang MF, Li YB, Gao XJ, Zhang HY and Lin S performed the study; Wang MF and Gao XJ collected and analyzed the data; Wang MF drafted the manuscript; Lin S and Zhu YY revised and finalized the manuscript; all authors read and approved the final version of the manuscript.
Supported by the Medical Innovation Project of Fujian Province, No. 2016-CX-33; and the Natural Science Foundation of Fujian Province the Pilot of Fujian Science and Technology Project, Nos. 2016Y0040 and 2017J01187.
Institutional review board statement: This study was reviewed and approved by the institutional board of the First Affiliated Hospital, Fujian Medical University.
Informed consent statement: Our patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after the patient agreed to treatment by verbal consent. Individuals cannot be identified by the data presented.
Conflict-of-interest statement: All authors declare no potential conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Yue-Yong Zhu, MD, PhD, Doctor, Professor, Liver Center, the First Affiliated Hospital, Fujian Medical University, No. 20 Chazhong Road, Taijiang District, Fuzhou 350005, Fujian Province, China.
Telephone: +86-591-87981660 Fax: +86-591-87982526
Received: June 25, 2018
Peer-review started: June 25, 2018
First decision: July 19, 2018
Revised: July 29, 2018
Accepted: August 26, 2018
Article in press: August 26, 2018
Published online: October 26, 2018

To evaluate the long-term efficacy and safety of autologous stem cell transplantation (SCT) for decompensated liver cirrhosis.


Consecutive patients with decompensated liver cirrhosis were included and assigned into the SCT group and non-transplantation (non-SCT) group according to whether they received SCT treatment. Patients were followed up for ten years. The long-term survival rate and incidence of hepatocellular carcinoma (HCC) were compared between groups.


A total of 159 patients were enrolled, including 27 cases in the SCT group and 132 cases in the non-SCT group. The baseline characteristics were significantly different between the two groups. Propensity score matching (PSM) was used to match SCT and non-SCT patients. After PSM, 92 subjects were enrolled in the final analysis, including 23 cases in the SCT group and 69 cases in the non-SCT group. The overall mortality was 73.9% and 55.1%, and the median survival period was 48 and 64 mo, respectively. However, no significant difference was found in the long-term survival rate between the two groups (P > 0.05). In addition, the incidence of HCC was higher in the SCT group than in the non-SCT group (47.8% vs 21.7%, P < 0.05). After adjusting for other covariates, SCT (OR = 3.065, 95%CI: 1.378-6.814) and age (OR = 1.061, 95%CI: 1.021-1.102) were independently correlated with the development of HCC in this decompensated liver cirrhosis cohort.


Autologous SCT may fail to improve the long-term efficacy and increase the incidence of HCC for decompensated liver cirrhosis. Close monitoring of HCC is strongly recommended in patients undergoing autologous SCT.

Keywords: Decompensated liver cirrhosis, Stem cell transplantation, Hepatocellular carcinoma, Propensity score matching

Core tip: Stem cell therapy has shown short-term efficacy and safety for treatment of liver cirrhosis. However, the tumorigenicity of stem cells requires increased attention.