Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Liver disease in particular, acute on chronic liver failure (ACLF) is a result of an acute insult to the liver on a previously compensated underlying chronic liver disease. ACLF has been defined as an acute hepatic insult manifesting as jaundice (serum bilirubin level>5 mg/dl) and coagulopathy (international normalized ratio>1.5), complicated within 4 weeks by ascites and/or encephalopathy in a patient with previously diagnosed or undiagnosed chronic liver disease. Liver transplant remains the only definitive therapy. This treatment option is limited due to lack of donors, high costs, lack of wide spread availability and limited expertise. There is need for other treatment option. The property of blood-derived stem cells that differentiate into multiple cell lineages provides an exciting opportunity of using these cells for tissue repair. For liver regeneration, bone marrow derived stem cells can provide a useful option. Recent studies have shown that G-CSF (granulocyte stimulating factor) induces mobilization of CD34 +bone marrow derived stem cells, increases hepatocyte growth factor and induces replication of hepatic progenitor cells. Studies have also shown use of G-CSF in acute on chronic liver failure also reduces the risk of sepsis, HRS, improves survival and reduces severity scores (CTP, MELD, SSOFA).

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