Can't go for liver transplant? There's hope still

Clinical trial on to explore the use of stem cells to reverse liver cirrhosis

A transplant can cure end-stage liver cirrhosis - hardening of the liver - but not all patients have this option.

For those who are not eligible for a transplant, an alternative may be in sight.

A clinical trial was launched yesterday to explore the use of stem cells to reverse liver cirrhosis.

In the study conducted by a multi-centre team led by the National University Hospital (NUH), doctors aim to determine if stem-cell therapy can improve liver function. Stem cells will be taken from a patient's own bone marrow and will be isolated and injected directly into the patient's liver to initiate the repair.

The $2.6 million Phase III trial will use biopsy and clinical measurements of liver function to test the efficacy, effectiveness and safety of the stem-cell treatment.

The study is funded by the National Medical Research Council, and a total of 46 patients will be recruited. It will run for four years, and patients will not need to bear the costs of stem-cell treatment.

Liver cirrhosis is caused by diseases such as chronic hepatitis B and non-alcoholic fatty liver disease. A liver transplant provides a definitive cure to end-stage cirrhosis. However, in Singapore, less than 5 per cent of end-stage liver cirrhosis patients receive a liver transplant.

The number of people on the waiting list for a liver transplant has been increasing over the years, according to statistics from the Ministry of Health.

Last year, there were 57 on the waiting list, up from nine in 2007. There are around 50 waiting for a liver transplant this year.

Many patients do not fulfil the eligibility criteria for a transplant because of other health complications or because they are above the age limit of about 70 years.

Ms Jac Low, 44, who works in the engineering sector, is optimistic. Her 70-year-old mother suffers from liver cirrhosis and is waiting to enter the trial.

"This brings new hope to patients, and my mother is happy to learn about it," said Ms Low.

While similar therapy treatments have been conducted overseas in countries such as Egypt and India, they have not been fully evaluated for efficacy.

Associate Professor Dan Yock Young, a senior consultant in the division of gastroenterology and hepatology at NUH, said: "We are conducting the study in a systematic and scientific manner in order to get definitive evidence of the effects of the treatment."

He said stem-cell therapy is not a substitute for a liver transplant but provides an option for those who are not eligible for one.

A version of this article appeared in the print edition of The Straits Times on July 12, 2017, with the headline 'Can't go for liver transplant? There's hope still'. Print Edition | Subscribe