Hepatocyte transplantation program: Lessons learned and future strategies

Abstract

This review aims to share the lessons we learned over time during the setting of the hepatocyte transplantation (HT) program at the Hepatic Cell Therapy Unit at Hospital La Fe in Valencia. New sources of liver tissue for hepatocyte isolation have been explored. The hepatocyte isolation and cryopreservation procedures have been optimized and quality criteria for assessment of functionality of hepatocyte preparations and suitability for HT have been established. The results indicate that: (1) Only highly viable and functional hepatocytes allow to recover those functions lacking in the native liver; (2) Organs with steatosis (≥ 40%) and from elderly donors are declined since low hepatocyte yields, viability and cell survival after cryopreservation, are obtained; (3) Neonatal hepatocytes are cryopreserved without significant loss of viability or function representing high-quality cells to improve human HT; (4) Cryopreservation has the advantage of providing hepatocytes constantly available and of allowing the quality evaluation and suitability for transplantation; and (5) Our results from 5 adults with acute liver failure and 4 from children with inborn metabolic diseases, indicate that HT could be a very useful and safe cell therapy, as long as viable and metabolically functional human hepatocytes are used.

Keywords: Hepatocyte transplantation, Hepatocyte isolation, Cell therapy, Inborn errors of metabolism, Neonatal hepatocytes, Cryopreservation

Core tip: Our aim is to share the lessons learned over time during the establishment of the hepatocyte transplantation (HT) program at our hospital and to envisage future strategies. The hepatocyte isolation and cryopreservation procedures have been optimized and, fast and sensitive criteria for assessment of functionality of hepatocyte preparations and suitability for transplantation have been set up. Neonatal hepatocytes show high-functional quality and could improve cell therapy applicability. Our results (patients with acute liver failure and inborn metabolic diseases) indicate that HT could be a safe and efficient therapy, as long as viable and high-quality, metabolically functional human hepatocytes are available.