***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: We here report nine liver cirrhosis ( LC ) patients that underwent autologous bone marrow cell infusion ( A BMI )  from the peripheral vein . Subjects were patients with LC with total bilirubin of less than 3.0 mg/dl , platelet count of more than 5 ( 10(10)/l ) , and no viable hepatocellular carcinoma on diagnostic imaging .  Autologous bone marrow ( BM ; 400 ml ) was isolated from the ilium under general anesthesia . Mononuclear cells ( MNCs ) were separated by cell washing and were infused via the peripheral vein . MNC characteristics were confirmed by fluorescence-activated cell sorting analysis ( CD34 , CD45 , and c-kit ) . After A BMI therapy , liver function was monitored by blood examination for 24 weeks . From 400 ml of BM , we obtained 7.81 + /- 0.98 x 10(9 ) MNCs . After washing , 5.20 + /- 0.63 x 10(9 ) MNCs were infused into patients with LC . Significant improvements in serum albumin levels and total protein were observed at 24 weeks after A BMI therapy ( p < .05 ) . Significantly improved Child-Pugh scores were seen at 4 and 24 weeks ( p < .05 ) . alpha-Fetoprotein and proliferating cell nuclear antigen ( PCNA ) expression in liver biopsy tissue was significantly elevated after A BMI therapy ( p < .05 ) . No major adverse effects were noted . In conclusion , A BMI therapy should be considered as a novel treatment for patients with decompensated LC OBJECTIVES : Severe alcoholic hepatitis has high short-term mortality . The aim of this study was to test the hypothesis that treatment of patients with alcoholic hepatitis with granulocyte colony-stimulating factor ( G-CSF ) might mobilize bone marrow – derived stem cells and promote hepatic regeneration and thus improve survival . METHODS : Forty-six patients with severe alcoholic hepatitis were prospect ively r and omized in an open study to st and ard medical therapy ( SMT ) plus G-CSF ( group A ; n=23 ) at a dose of 5 μg/kg subcutaneously every 12 h for 5 consecutive days or to SMT alone ( group B ; n=23 ) at a tertiary care center . We assessed the mobilization of CD34 + cells on day 6 , Child-Turcotte-Pugh ( CTP ) , model for end-stage liver disease ( MELD ) , and modified Maddrey ’s discriminant function ( mDF ) scores , and survival until day 90 . RESULTS : There was a statistically significant increase in the number of CD34 + cells in peripheral blood in group A as compared with group B ( P=0.019 ) after 5 days of G-GSF therapy . There was a significant reduction in median Δ change% in CTP , MELD , and mDF at 1 , 2 , and 3 months in group A as compared with group B ( P<0.05 ) . There was marked improvement in survival in group A as compared with group B ( 78.3 % vs. 30.4 % ; P=0.001 ) at 90 days . CONCLUSIONS : G-CSF is safe and effective in the mobilization of hematopoietic stem cells and improves liver function as well as survival in patients with severe alcoholic hepatitis BACKGROUND Cirrhosis , the end stage of progressive hepatic fibrosis , is characterized by distortion of the hepatic architecture and the formation of regenerative nodules . Liver transplantation is one of the few available therapies for such patients . However , due to a severe shortage of organ donors , surgical complications , transplant rejection and the high cost of this procedure much interest has focused on research to find new treatment modalities for this disease . There is accumulating evidence for the contribution of bone marrow stem cells to participate in liver regeneration . METHODS Here we report on six patients with end stage liver disease who were subjected to intraportal administration of autologous bone marrow-derived CD133(+ ) in comparison to mononuclear cells in short-term ( 6 months ) and long-term ( 24 months ) follow up . RESULTS There were no adverse effects in any of the patients during the short- and long-term follow up period . Moreover , there were no significant alterations of liver function parameters , liver enzymes , serum albumin , creatinine , serum bilirubin and /or liver volume after transplantation of both types of autologous cells in these patients . CONCLUSION Our study has shown both the safety and feasibility of this type of liver cell therapy and may be a bridge to liver transplantation . The trial was registered with NIH clinical trials ( www . clinical trials.gov ) as identifier : NCT00713934 OBJECTIVES : Recent advances in regenerative medicine , including hematopoietic stem cell ( HSC ) transplantation , have brought hope for patients with severe alcoholic liver cirrhosis ( ALC ) . The aim of this study was to assess the safety and efficacy of administering autologous exp and ed mobilized adult progenitor CD34 + cells into the hepatic artery of ALC patients and the potential improvement in the liver function . METHODS : Nine patients with biopsy-proven ALC , who had abstained from alcohol for at least 6 months , were recruited into the study . Following granulocyte colony-stimulating factor ( G-CSF ) mobilization and leukapheresis , the autologous CD34 + cells were exp and ed in vitro and injected into the hepatic artery . All patients were monitored for side effects , toxicities , and changes in the clinical , hematological , and biochemical parameters . RESULTS : On average , a five-fold expansion in cell number was achieved in vitro , with a mean total nucleated cell count ( TNCC ) of 2.3 × 108 pre infusion . All patients tolerated the procedure well , and there were no treatment-related side effects or toxicities observed . There were significant decreases in serum bilirubin ( P < 0.05 ) 4 , 8 , and 12 wk post infusion . The levels of alanine transaminase ( ALT ) and aspartate transaminase ( AST ) showed improvement through the study period and were significant ( P < 0.05 ) 1 wk post infusion . The Child-Pugh score improved in 7 out of 9 patients , while 5 patients had improvement in ascites on imaging . CONCLUSION : It is safe to mobilize , exp and , and reinfuse autologous CD34 + cells in patients with ALC . The clinical and biochemical improvement in the study group is encouraging and warrants further clinical trials AIM To assess the utility of an autologous CD34(+ ) and CD133(+ ) stem cells infusion as a possible therapeutic modality in patients with end-stage liver diseases . METHODS One hundred and forty patients with end-stage liver diseases were r and omized into two groups . Group 1 , comprising 90 patients , received granulocyte colony stimulating factor for five days followed by autologous CD34(+ ) and CD133(+ ) stem cell infusion in the portal vein . Group 2 , comprising 50 patients , received regular liver treatment only and served as a control group . RESULTS Near normalization of liver enzymes and improvement in synthetic function were observed in 54.5 % of the group 1 patients ; 13.6 % of the patients showed stable states in the infused group . None of the patients in the control group showed improvement . No adverse effects were noted . CONCLUSION Our data showed that a CD34(+ ) and CD133(+ ) stem cells infusion can be used as supportive treatment for end-stage liver disease with satisfactory tolerability BACKGROUND / AIMS To evaluate feasibility , safety and pattern of bone marrow-derived cells ( BMC ) mobilization in patients with end stage liver cirrhosis following granulocyte-colony stimulating factor ( G-CSF ) administration . METHODS Eight patients with severe liver cirrhosis ( Child-Pugh score B-C , spleen diameter less than 170 mm ) were included . They were treated with G-CSF ( 5 microg/kg b.i.d for three consecutive days ) to mobilize BMC , evaluated as circulating CD34+ve cells ( flow cytometry ) and myeloid CFU-GM progenitors ( in vitro colony growth assay ) . Co-expression in CD34+ve cells markers of differentiation ( Thy1 , CD133 , CXCR4 , c1qRp ) were investigated on CD34+ve cells by double direct immunofluorescence . Data from 40 healthy haematopoietic stem cell donors were used as controls . RESULTS Mobilization of CD34+ve cells occurred in all patients . It was paralleled by expansion of circulating CFU-GM progenitors . Circulating CD34+ve cells co-expressed epithelial and stem cell markers in both cirrhotics and volunteer stem cell donors .  G-CSF  was well tolerated , no adverse event occurred , a significant reversible increase of splenic longitudinal diameter was observed . CONCLUSIONS ( i ) G-CSF mobilization of BMC co-expressing epithelial and stem markers occurred in all cirrhotic patients ; ( ii ) splenomegaly up to 170 mm does not prevent safe BMC mobilization following G-CSF in patients with end stage liver disease ; ( iii ) mobilized BMC may represent an easy immature cell source potentially useful for novel approaches for liver regeneration BACKGROUND & AIMS A consensus has been reached that liver donor allocation should be based primarily on liver disease severity and that waiting time should not be a major determining factor . Our aim was to assess the capability of the  Model for End-Stage Liver Disease ( MELD ) score  to correctly rank potential liver recipients according to their severity of liver disease and mortality risk on the OPTN liver waiting list . METHODS The MELD model predicts liver disease severity based on serum creatinine , serum total bilirubin , and INR and has been shown to be useful in predicting mortality in patients with compensated and decompensated cirrhosis . In this study , we prospect ively applied the MELD score to estimate 3-month mortality to 3437 adult liver transplant c and i date s with chronic liver disease who were added to the OPTN waiting list at 2A or 2B status between November , 1999 , and December , 2001 . RESULTS In this study cohort with chronic liver disease , 412 ( 12 % ) died during the 3-month follow-up period . Waiting list mortality increased directly in proportion to the listing MELD score . Patients having a MELD score < 9 experienced a 1.9 % mortality , whereas patients having a MELD score > or = 40 had a mortality rate of 71.3 % . Using the c-statistic with 3-month mortality as the end point , the area under the receiver operating characteristic ( ROC ) curve for the MELD score was 0.83 compared with 0.76 for the Child-Turcotte-Pugh ( CTP ) score ( P < 0.001 ) . CONCLUSIONS These data suggest that the MELD score is able to accurately predict 3-month mortality among patients with chronic liver disease on the liver waiting list and can be applied for allocation of donor livers AIM To evaluate safety and feasibility of autologous bone marrow-enriched CD34 + hematopoietic stem cell Tx through the hepatic artery in patients with decompensated cirrhosis . METHODS Four patients with decompensated cirrhosis were included . Approximately 200 mL of the bone marrow of the patients was aspirated , and CD34 + stem cells were selected . Between 3 to 10 million CD34 + cells were isolated . The cells were slowly infused through the hepatic artery of the patients . RESULTS Patient 1 showed marginal improvement in serum albumin and no significant changes in other test results . In patient 2 prothrombin time was decreased ; however , her total bilirubin , serum creatinine , and Model of End-Stage Liver Disease ( MELD ) score worsened at the end of follow up . In patient 3 there was improvement in serum albumin , porthrombin time ( PT ) , and MELD score . Patient 4 developed radiocontrast nephropathy after the procedure , and progressed to type 1 hepatorenal syndrome and died of liver failure a few days later . Because of the major side effects seen in the last patient , the trial was prematurely stopped . CONCLUSION Infusion of CD34 + stem cells through the hepatic artery is not safe in decompensated cirrhosis . Radiocontrast nephropathy and hepatorenal syndrome could be major side effects . However , this study does not preclude infusion of CD34 + stem cells through other routes 
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Discussion This systematic review will identify the available evidence on the effectiveness of cell therapies in patients with CLD and in ACLF subgroup .