***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction We have assessed the utility of autologous mesenchymal stem cell ( MSC ) peripheral vein infusion as a possible therapeutic modality for patients with end-stage liver diseases . Methods Forty patients with post-hepatitis C virus ( HCV ) end-stage liver disease were r and omized into two groups : Group 1 ( GI ) : 20 patients who received granulocyte colony-stimulating factor ( G-CSF ) for 5 days followed by autologous MSCs peripheral-vein infusion and group 2 ( GII ) : 20 patients who received regular liver-supportive treatment only ( control group ) . Results In MSC-infused patients ( GI ) , 54 % showed near normalization of liver enzymes and improvement in liver synthetic function . Significant changes were reported in albumin ( P = 0.000 ) , bilirubin ( P = 0.002 ) , increased international normalized ratio ( INR ) ( P = 0.017 ) , prothrombin concentration ( P = 0.029 ) and alanine transaminase ( ALT ) levels ( P = 0.029 ) , with stabilization of clinical and biochemical status in 13 % of cases . None of the patients in GII showed any significant improvement . Hepatic fibrosis was assessed in GI by detection of procollagen IIIC peptide level ( PIIICP ) and procollagen III N peptide level ( PIIINP ) . The pretreatment values of s-PIIICP and s-PIIINP were 9.4 ± 4.2 and 440 ± 189 , respectively , with a decrease to 8.1 ± 2.6 and 388 ± 102 , respectively , 3 months after MSC therapy . However , the difference was statistically nonsignificant ( P = 0.7 ) . A significant correlation coefficient was reported after 3 months between the s-PIIINP and prothrombin concentration ( P = -0.5 ) and between s-PIIICP and ascites ( P = 0.550 ) . Conclusions First , autologous MSC infusion into a peripheral vein is as effective as the previously reported intrahepatic infusion . Second , MSCs have a supportive role in the treatment of end-stage liver disease , with satisfactory tolerability and beneficial effects on liver synthetic functions and hepatic fibrosis . Third , IV infusion of MSCs after G-CSF mobilization improves s-albumin within the first 2 weeks and prothrombin concentration and alanine Taransaminase after 1 month . According to the data from this current study and those previously reported by our group , we recommend further studies on patients ’ infusion with pure CD133 and CD34 followed by IV infusion of in vitro-differentiated MSCs within 1 week and another infusion after 3 months . Trial registration Clinical Trials.gov NCT01729221 . Registered 17 November 2012 BACKGROUND The st and ard treatment for decompensated liver cirrhosis is liver transplantation . However , it has several limitations . Recent animal studies suggest that bone marrow stem cell transplantation can lead to regression of liver fibrosis . The objective of this study was to determine the safety and feasibility of autologous bone marrow-mesenchymal stem cell transplantation in patients with decompensated liver cirrhosis . METHODS In this phase 1 trial , four patients with decompensated liver cirrhosis were included . Their bone marrow was aspirated , mesenchymal stem cells were cultured , and a mean 31.73 x 10(6 ) mesenchymal stem cells were infused through a peripheral vein . Primary outcomes were evaluating the safety and feasibility of the work . Secondary outcomes were evaluating changes in the model for end-stage liver disease score , and the quality of life of the patients . RESULTS There were no side-effects in the patients during follow-up . The model for end-stage liver disease scores of patients 1 , and 4 improved by four and three points , respectively by the end of follow-up . Furthermore , the quality of life of all four patients improved by the end of follow-up . Using SF-36 question naire , the mean physical component scale increased from 31.44 to 65.19 , and the mean mental component scale increased from 36.32 to 65.55 . CONCLUSION Mesenchymal stem cell transplantation seems to be feasible and safe in the treatment of decompensated liver cirrhosis The study was aim ed to evaluate the effect of autologous transplantation of BM-derived undifferentiated and differentiated MSCs in cirrhotic patients following chronic hepatitis C virus infection . Twenty-five patients with Child C liver cirrhosis , MELD score > 12 were included . They were divided into 2 groups . Group I , the MSCs group ( n = 15 ) , this group was subdivided into two subgroups : Ia & Ib ( undifferentiated and differentiated respectively ) . Group II ( control group ; n = 10 ) involved patients with cirrhotic liver under conventional supportive treatment .  Ninety ml BM was aspirated from the iliac bone for separation of MSCs .  Surface expression of CD271 , CD29 and CD34 were analyzed using flowcytometry . Hepatogenesis was assessed by immunohistochemical expression of OV6 , AFP and albumin . Finally approximately 1 million MSCs/Kg were suspended in saline and were placed in blood bag and injected slowly intravenously over 15 min at a rate of 5 drops/min in one session . Follow up of patients at 3 and 6 months postinfusion revealed partial improvement of liver function tests with elevation of prothrombin concentration and serum albumin levels , decline of elevated bilirubin and MELD score in MSCs group . Statistical comparisons between the two subgroups ( group Ia & Ib ) did not merit any significant difference regarding clinical and laboratory findings . In conclusion : Bone marrow MSCs transplantation either undifferentiated or differentiated can be used as a potential treatment for liver cirrhosis Mortality from hepatitis B virus (HBV)-related acute-on-chronic liver failure ( ACLF ) is high due to limited treatment options . Pre clinical and clinical investigations have proved that treatment with mesenchymal stromal cells ( MSCs ) is beneficial for recovery from liver injury . We hypothesized that the outcome of HBV-related ACLF would be improved by MSC treatment . From 2010 to 2013 , 110 patients with HBV-related ACLF were enrolled in this open-label , nonblinded r and omized controlled study . The control group ( n = 54 ) was treated with st and ard medical therapy ( SMT ) only . The experimental group ( n = 56 ) was infused weekly for 4 weeks with 1.0 to 10 × 105 cells/kg allogeneic bone marrow-derived MSCs and then followed for 24 weeks . The cumulated survival rate of the MSC group was 73.2 % ( 95 % confidence interval 61.6%-84.8 % ) versus 55.6 % ( 95 % confidence interval 42.3%-68.9 % ) for the SMT group ( P = 0.03 ) . There were no infusion-related side effects , but fever was more frequent in MSC compared to SMT patients during weeks 5 - 24 of follow-up . No carcinoma occurred in any trial patient in either group . Compared with the control group , allogeneic bone marrow-derived MSC treatment markedly improved clinical laboratory measurements , including serum total bilirubin and Model for End-Stage Liver Disease scores . The incidence of severe infection in the MSC group was much lower than that in the SMT group ( 16.1 % versus 33.3 % , P = 0.04 ) . Mortality from multiple organ failure and severe infection was higher in the SMT group than in the MSC group ( 37.0 % versus 17.9 % , P = 0.02 ) . CONCLUSION Peripheral infusion of allogeneic bone marrow-derived MSCs is safe and convenient for patients with HBV-related ACLF and significantly increases the 24-week survival rate by improving liver function and decreasing the incidence of severe infections . ( Hepatology 2017;66:209 - 219 ) OBJECTIVE To evaluate the safety of human umbilical cord derived-mesenchymal stem cell ( UC-MSC ) transplantation therapy in patients with decompensated liver cirrhosis . METHODS UC-MSCs were transplanted intravenously into patients with decompensated liver cirrhosis .  Serum levels of glucose ( GLU ) , total cholesterol ( TC ) , blood urea nitrogen ( BUN ) , alpha fetoprotein ( AFP ) , white blood cells ( WBC ) , and prothrombin activity ( PA ) were detected at different time points after UC-MSCs transplantation . RESULTS Most UC-MSC transplanted patients experienced an improvement in quality of life , to varying degrees . With the exception of low- grade fever in a few patients , side effects and oncogenic events were rare ( treatment group : 1/38 vs. control group : 1/16 ; P more than 0.05 ) . The UC-MSCs transplantation showed no effect on GLU , TC , BUN , AFP , WBC , or PA . CONCLUSION UC-MSCs transplantation in patients with decompensated liver cirrhosis is safe and may improve the patient 's quality of life Bone marrow-derived mesenchymal stem cell ( BM-MSC ) transplantation has been suggested as an effective therapy for liver cirrhosis . The efficacy and safety of autologous BM-MSC transplantation in the treatment of alcoholic cirrhosis were investigated . Seventy-two patients with baseline biopsy-proven alcoholic cirrhosis who had been alcohol-abstinent for more than 6 months underwent a multicenter , r and omized , open-label , phase 2 trial . Patients were r and omly assigned to three groups : one control group and two autologous BM-MSC groups that underwent either one-time or two-time hepatic arterial injections of 5 × 107 BM-MSCs 30 days after BM aspiration . A follow-up biopsy was performed 6 months after enrollment , and adverse events were monitored for 12 months . The primary endpoint was improvement in fibrosis quantification based on picrosirius red staining . The secondary endpoints included liver function tests , Child-Pugh score , and Model for End-stage Liver Disease score . Outcomes were analyzed by per- protocol analysis . In terms of fibrosis quantification ( before versus after ) , the one-time and two-time BM-MSC groups were associated with 25 % ( 19.5 ± 9.5 % versus 14.5 ± 7.1 % ) and 37 % ( 21.1 ± 8.9 % versus 13.2 ± 6.7 % ) reductions in the proportion of collagen , respectively ( P < 0.001 ) . In the intergroup comparison , two-time BM-MSC transplantation in comparison with one-time BM-MSC transplantation was not associated with improved results in fibrosis quantification ( P > 0.05 ) . The Child-Pugh scores of both BM-MSC groups ( one-time 7.6 ± 1.0 versus 6.3 ± 1.3 and two-time 7.8 ± 1.2 versus 6.8 ± 1.6 ) were also significantly improved following BM-MSC transplantation ( P < 0.05 ) . The proportion of patients with adverse events did not differ among the three groups . CONCLUSION Autologous BM-MSC transplantation  safely improved histologic fibrosis and liver function in patients with alcoholic cirrhosis . ( Hepatology 2016;64:2185 - 2197 ) BACKGROUND & AIMS There has been great interest in recent years to take advantage of bone marrow stem cells to treat cirrhosis . Our uncontrolled trial showed promising results for bone marrow mesenchymal stem cell ( MSC ) transplantation in cirrhosis . Therefore , we conducted a r and omized , placebo-controlled trial to evaluate the efficacy of autologous MSC transplantation in cirrhosis . METHODS The enrolled patients with decompensated cirrhosis were r and omly assigned to receive MSC or placebo infusions . A median of 195 million ( range : 120 - 295 million ) cultured MSCs were infused through a peripheral vein . The primary outcome was absolute changes in MELD score . Secondary outcomes were absolute changes in Child score , liver function tests and liver volumes between the MSC and placebo group 12 months after infusion . RESULTS A total of 27 patients were enrolled . Of these , 15 patients received MSC  and 12 patients received placebo .  One patient in the MSC group and one patient in the placebo group were lost to follow-up . Three patients in the MSC group died of liver failure 3 months ( one patient ) , or 5 months ( two patients ) after cellular infusion . The baseline MELD scores of the deceased patients were significantly higher than those who remained alive in either group ( 20.0 vs. 15.1 ; P = 0.02 ) . The absolute changes in Child scores , MELD scores , serum albumin , INR , serum transaminases and liver volumes did not differ significantly between the MSC and placebo groups at 12 months of follow-up . CONCLUSION Based on this r and omized controlled trial , autologous bone 
    Output:
    
According to a meta- analysis of 23 controlled studies , compared with conventional treatment MSC therapy  significantly improves liver function in patients with liver disease  in terms of the model of end-stage liver disease score , albumin , alanine aminotransferase , and total bilirubin levels , and prothrombin time , up to 6 months after administration .
Subgroup analyses showed that a single MSC injection was more effective than multiple injections , MSC administration was more effective via the hepatic artery than the peripheral vein , and MSCs derived from bone marrow were more effective than those derived from the umbilical cord .
Conclusions MSC-based therapy is relatively safe and improves liver function during the first 6 months after administration .
A single injection administration via the hepatic artery and MSCs derived from bone marrow are optimal in terms of improving liver function .