Stem Cell Transplant for Advanced Stage Liver Disorders: Current Scenario and Future Prospects.

Chronic liver disorders (CLD), caused by the life style patterns like alcoholism or by non-alcoholic fatty liver disease or because of virus-mediated hepatitis, affect a large population fraction across the world. CLD progresses into end-stage disease with high mortality rate. Liver transplant is the only approved treatment available for such end-stage patients. However, numbers of liver transplants are limited due to limited availability of suitable donors and sky high cost of performing the procedure. Under such circumstances, stem cell (SC) mediated liver regeneration has emerged as a potent therapeutic alternatice approach.This review aims to critically analyze current status and future prospects of stem cell-based interventions for end-stage liver diseases. The clinical studies undertaken, mechanism underlying therapeutic effects and future directions are examined.We searched clinical trial databases like https://clinicaltrials.gov.in and http://www.isrctn.com to identify randomized, non-randomized and controlled studies undertaken with keywords like "liver disorder and mesenchymal stem cells (MSCs)", "liver cirrhosis and MSCs" and "liver disorder and SCs". Furthermore, https://www.ncbi.nlm.nih.gov/pubmed/ database was also explored with similar keywords for finding out the available reports and their critical analyses.The search results yielded a significant number of studies which used bone marrow-derived stem cells, MSCs and hepatocytes. The studies clearly indicated that SCs play a key role in hepato-protection process by some mechanisms involving anti-inflammatory, auto-immune-suppression, angiogenesis and anti-apoptosis. Further, studies indicated that SCs derived paracrine factors promote angiogenesis, reduce inflammation and inhibit hepatocyte apoptosis.The SC-based interventions provide significant improvement in patients with CLD, however, there is a need of randomized, controlled studies with analysis of long-term follow-up.