Abstract: Objective To explore the therapeutic efficacy and safety of autologous transplantation of bone marrow (BM) derived mesenchymal stem cells (BMSCs) in the treatment of decompensated liver cirrhosis. Methods Total of 17 patients with decompensated live cirrhosis were enrolled in the study. About 200 ml BM was obtained from each patient to isolate the MSCs. The BMSCS were isolated and purified by the density centrifugation method in our stem cell laboratory. The purified BMSCs (20 ml, suspended in normal saline) were transplanted into the liver via left hepatic artery. The improvement in symptoms, signs,
and blood biochemistry were observed. Results Four weeks after transplantation, 16 (94.1%) patients showed improvement in fatigue, 14 (82.4%) patients had better appetite, and for 12 (70.5%) patients, the ascites decreased or disappeared after one year. No serious adverse reactions and serious postoperative complications occurred. There was a significant decrease in the serum levels of ALT and AST 8 weeks after transplantation (P = 0.0093, 0.0173). Twelve weeks after transplantation, there was significant improvement in the levels of albumin (ALB), cholinesterase (CHE), prothrombin time (PT), prothrombin activity (PTA) and fibrinogen (FIB) (P = 0.039, 0.028, 0.034, 0.041, 0.031, respectively). However, no significant changes were found in serum bilirubin level and the percentage of CD3, CD4, and CD8 (P = 0.895). One year after MSC transplantation, there was a significant improvement in the severity of fibrosis as indicated by improved hepatic fibrosis markers (P = 0.016, 0.049, 0.028, 0.021, respectively). One months after treatment, there was a decrease in the oblique occipital frontal diameter of the hepatic left lobe, and an increase in the superior inferior diameter of the hepatic left lobe by the ultrasonic examination (P = 0.0451, 0.0428). However, the oblique occipital frontal diameter of the right hepatic lobe showed no significant changes. Six months after the MSC treatment, there was a significant reduction in the spleen size, spleen vein diameter, and portal vein diameter (P = 0.0324, 0.0314, 0.0416, respectively). Conclusions Autologous transplantation of BMSCs is a safe and effective approach for the treatment of patients with decompensated liver cirrhosis. Patients receiving autologous BMSCs exhibited marked improvement in liver function, the severity of liver fibrosis, and the overall quality of life.