End Stage Liver Diseases
End stage liver disease /liver cirrhosis
Many different factors and conditions can cause end stage liver disease including:
- Non-alcoholic fatty liver disease NAFLD
- Chronic viral infections of the liver
- Chronic Alcoholism
- Drug-induced liver damage etc.
” Cirrhosis is the last stage of chronic liver disease, characterized by disturbance of hepatic architecture, the creation of extensive nodules, vascular rearrangement, neo- angiogenesis, and extracellular matrix deposition. Chronic liver disease is a condition in which the liver’s functions gradually deteriorate. “
The standard treatment for decompensated liver cirrhosis is liver transplantation. However, it has several limitations such as long waiting list, high cost, and several Complications.
Autologous or Allogenic mesenchymal stem cells injected intravenous or preferably thru portal vein possibly carry out the process of engrafting of the liver and are able to overall reduce liver scarring along with stimulating the regenerative process of the liver.

How it is done
Thorough evaluation with ultrasonography /CT scan and complete haematogical and biochemical tests including albumin and prothrombin time and a “model for end-stage liver disease” (MELD) score is done.
Under local anaesthesia 100 cc fat is aspirated. If possible approximately 150 cc of bone marrow is also aspirated from iliac crest or Tibia.
Fat and bone marrow are processed to isolate various types of stem cells (haematopoietic, mesenchymal, endothelial and very small embryonic stem cells)
In cases which are very compromised allogenic umbilical cord derived mesenchymal stem cells is an alternative option
These cells are injected:
- Intravenous
- Into portal vein via angiographic guidance Intravenous route needs multiple administration and higher dose of cells




What to expect
- Liver function tests improved significantly in 45 % .in 10% very close to normal levels
- Model for end-stage liver disease” (MELD) score improved significantly in 45 % of patients and were maintained till 2 years.
- The improvement was most significant by 4- 6 months post procedure though changes could be observed as early as one week in some patients.
- CT showed that liver volumes in 30 % increased by six months post procedure.
- The doses of diuretics were reduced to half in 70 %.
- 60 % had good reduction in Ascites
- SF-36 questionnaire showed that the quality of life of all patients had significantly till 2yrs follow up.


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2 nd Floor Hb, Specialty Hospital & Research Institute, Near Bhoorarani Gate,
Kashipur Road, Rudrapur,
Udham Singh Nagar, Uttarakhand,
India 263153
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