Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12334
Peer-review started: June 3, 2015
First decision: August 26, 2015
Revised: September 16, 2015
Accepted: October 17, 2015
Article in press: October 20, 2015
Published online: November 21, 2015
The existing mismatch between the great demand for liver transplants and the number of available donor organs highlights the urgent need for alternative therapeutic strategies in patients with acute or chronic liver failure. The rapidly growing knowledge on stem cell biology and the intrinsic repair processes of the liver has opened new avenues for using stem cells as a cell therapy platform in regenerative medicine for hepatic diseases. An impressive number of cell types have been investigated as sources of liver regeneration: adult and fetal liver hepatocytes, intrahepatic stem cell populations, annex stem cells, adult bone marrow-derived hematopoietic stem cells, endothelial progenitor cells, mesenchymal stromal cells, embryonic stem cells, and induced pluripotent stem cells. All these highly different cell types, used either as cell suspensions or, in combination with biomaterials as implantable liver tissue constructs, have generated great promise for liver regeneration. However, fundamental questions still need to be addressed and critical hurdles to be overcome before liver cell therapy emerges. In this review, we summarize the state-of-the-art in the field of stem cell-based therapies for the liver along with existing challenges and future perspectives towards a successful liver cell therapy that will ultimately deliver its demanding goals.
Core tip: Liver transplantation is the only effective treatment for end-stage liver diseases, but its application is limited mainly due to donor shortage. In order to fulfil the unmet medical needs in the field, alternative, cell-based therapies for the treatment of end-stage hepatic diseases are under investigation. This review aims to summarize the state of the art on stem cell-based approaches towards liver regeneration as well as to critically discuss and highlight new perspectives and challenges.