Hepatocyte transplantation in a 4-year-old girl with peroxisomal biogenesis disease: technique, safety, and metabolic follow-up.

Sokal, Etienne;Smets, Françoise;Bourgois, Annick;Van Maldergem, Lionel;Soriano, Humberto E;et.al.

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Authors
  • Sokal, EtienneUCLouvain
    author
  • Smets, FrançoiseUCLouvain
    author
  • Bourgois, AnnickUCLouvain
    author
  • Van Maldergem, Lionel
    author
  • Buts, Jean-PaulUCLouvain
    author
  • Reding, RaymondUCLouvain
    author
  • Bernard Otte, JeanUCLouvain
    author
  • Evrard, VeerleUCLouvain
    author
  • Latinne, DominiqueUCLouvain
    author
  • Vincent, Marie-FrançoiseUCLouvain
    author
  • Soriano, Humberto E
    author
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Abstract
Hepatocyte transplantation is an investigational alternative to orthotopic liver transplantation to treat liver based inborn errors of metabolism. We report successful hepatocyte transplantation in a 4-year-old girl with infantile Refsum disease. Hepatocytes were isolated from the left liver segment of two male donors using a classic two-step perfusion method. Fresh cells were transplanted first and then cryopreserved cells, for a total of 2 billion cells. Total bile acids and abnormal dihydroxycoprostanoïc acid markedly decreased in the patient's serum, indicating resolution of cholestasis and re-population of liver cells. Pipecholic acid decreased by 40% and c26:c22 fatty acid ratio by 36% after 18 months. Donor chromosomes sequences were detected on biopsy posttransplant, indicating engraftment. Hepatocyte transplantation is a safe and promising technique in the treatment of rare inborn errors of metabolism. Future improvements of cell viability and prevention of apoptosis may increase engraftment and subsequent re-population.
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