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Methicilin resistance Staphylococcus aureus ( MRSA) infections are the major challenges in hospitals, especially in the burn units. The use of molecular typing methods is essential for tracking the spread of S. aureus infection and epidemiological investigations. The aim of this study was to find the profile of the spa types and also the prevalence of each SCC mec type of S. aureus strains in a central burn hospital in southwest of Iran. A total of 81 non-duplicate S. aureus were isolated from burn patients between April 2011 and February 2012. The susceptibility of the isolates against 13 different antibiotics was tested by disk agar diffusion ( DAD) method. MRSA strains were identified by amplification of mecA gene. Multiplex-polymerase chain reaction ( PCR) technique was used to determine the SCC mec types of MRSA strains and all the S. aureus isolates were typed by spa typing method. Detection of mecA gene showed that 70 (86.4%) of the isolates were MRSA. The highest rate of resistance was observed for penicillin (97.5%) and erythromycin (77.8%). None of the isolates were resistant to vancomycin. Sixty-seven of the 70 MRSA isolates harbored only SCC mec type III and three untypeable isolates. Five different spa types were detected. The most common spa types were t037 (42.5%) and t631 (34.5%) and were only found in MRSA isolates. Only SCC mec type III was found in burn patients which emphasizes the HA- MRSA origin of these strains. Only five different spa types identified in this study are in accordance with one SCC mec type which indicates that a limited number of bacterial colons are circulated in the burn unit in this hospital. [ABSTRACT FROM AUTHOR]

Aims: Rapid harvesting of autogenous graft over a wire is an optional way in trauma surgery and it places the inverted conduit so that its adventitial layer is within the lumen of the graft. Our aim of this study was to compare the patency of inverted autogenous graft vs noninverted graft in dogs. Settings and Design: Experimental animal models. Materials and Methods: In this experimental study, 12 dogs were anesthetized and 10 cm of the external jugular vein was excised. The vein was equally divided into two 5-cm sections. One section was inverted and the other was left intact. Afterward, 5 cm of both the femoral arteries were removed and the right (inverted) and the left (not inverted) arteries were grafted, respectively. The patency of the arteries was evaluated by Color Doppler ultrasonography immediately postoperation and up to 6 months thereafter. Statistical Analysis: Data were analyzed with Fisher's exact test using SPSS version 15. P value below 0.05 was significant. Results: None of the 12 inverted vein grafts were patent at 3rd to 14th days follow-up with Doppler ultrasonography. All of them were completely obstructed by thrombosis. However, 11 (92%) of the noninverted vein grafts were patent both at 3 and 6 months follow-up. One of the noninverted grafts was almost completely obstructed with thrombosis (90%) and the other 2 were incompletely obstructed with intimal thickening. Conclusions: Despite many favorable results in the previous studies with regard to excellent patency of inverted vein graft, our results were disappointing and we recommend using the graft in the right direction and taking care to preserve the intima intact. [ABSTRACT FROM AUTHOR]

Background: The Shiraz Liver Transplant Audit collects information on all liver transplantations that are carried out in Iran. In this paper, we describe these transplantations and their outcomes in adult patients according to the primary liver disease diagnosis, type and period of transplantation. Methods: A prospective cohort study carried on 364 orthotropic liver transplantations in Shiraz Namazi hospital from June 2002 to July 2008. Actual survival rates, calculated using the Kaplan-Meier method, were compared using the log-rank test. To determine independent prognostic factors for survival, the Cox regression model was used. Findings: Among the 364 patients included in this study (age range: 13-39 years; 327 [68.1%] men), the most common causes of liver disease were hepatitis B and C virus infection (25.8). Overall patient survival rates at 1, 2, 5 and 6 years after Orthotopic Liver Transplantation (OLT) were 83.7%, 82%, 82% and 82%, respectively. Mean and SE of Survival time of patients were 64.6 ± 1.7 (CI95%: 61.2-67.9). Short time and long time survival of these patients in both sexes and between age groups were similar. Multivariable analysis demonstrated that these improvements only be explained by donors age between 20-40 years old. Conclusion: In summary, Orthotopic Liver Transplantation has developed into a safe and successful treatment for end-stage liver disease with satisfactory long-terms results. Our experience with liver transplantation indicates comparable success rate to similar reports. [ABSTRACT FROM AUTHOR]

Background: Post-transplantation lymphoproliferative disorders (PTLD) are a spectrum of diseases defined as polyclonal or monoclonal proliferations of lymphocytes which occur after solid organ transplants. In this study, we report our first experiences with PTLD following liver transplantation in Iran. Patients and Methods: We retrospectively analyzed five cases of PTLD which followed liver transplantation among more than 550 liver transplants in our center. Of these, three were pediatric cases and two were adults. The underlying causes were tyrosinemia, autoimmune hepatitis, and progressive familial intrahepatic cholestasis (PFIC) in the three pediatric cases. HCV hepatitis was the primary cause for cirrhosis in one of the adults and the other adult was labeled as cryptogenic cirrhosis. All cases, except for one, developed PTLD during the first year following liver transplantation. Results: Patients were diagnosed as PTLD, B-cell, MALT and Hodgkin-like (according to the WHO classification of PTLD). The three pediatric patients died despite discontinuation of immunosuppressive drugs and chemotherapy. Fortunately both adult patients, until now, are still alive. Conclusion: The incidence of PTLD in our center is lower than previous reports from other centers (0.9%), with a 60% mortality rate and worse prognosis in the pediatric age group. [ABSTRACT FROM AUTHOR]

We reviewed records of 35 pediatric liver transplant recipients who were operated at the Shiraz Organ Transplant Center between April 1998 and April 2005 to gather demographic data, primary diagnosis, duration of hospital stay, source of graft, mortality, and surgical (vascular, biliary, fluid collection) and medical (infection, respiratory, neurological, cardiovascular, and gastrointestinal) complications. Among 23 male and 12 female pediatric liver transplant recipients (mean age: 11.8±4.9 years) with a mean hospital stay duration of 23.3±20.3 days, the postoperative complications included biliary leakage (7.20%), biliary stricture (3.10%), biliary obstruction (3.10%), pleural effusion (9.26%), lung collapse (n=1) pulmonary hemorrhage (n=1), and vascular complications of portal and hepatic vasculature (n=10, 28.6%); and infections of the peritoneum, lung, wound site, and urinary tract (n=10; 28.6%). Acute cellular rejection was documented in 6 (17.1%) recipients. Overall, 13 (37.1%) children died. [ABSTRACT FROM AUTHOR]

Background: Bacterial infection in early period after liver transplant (LT) is the main cause of morbidity and mortality; however, data on children is limited. Methods: To investigate the frequency, characteristics, and the associated factors of bacterial infection during hospitalization after LT, we prospectively enrolled all consecutive children with LT for a one‐year, case‐control study at the unique referral center of pediatric LT in Iran. Results: Eighty‐five events of bacterial infection were detected among 51 out of 94 LT recipients (54.3%) (infection group). Forty‐three patients without bacterial infection constituted the control group. The frequency of bacterial infection based on the 51 microbiologically documented events was 31.9% (30 out of 94 patients). Major site of bacterial isolation were abdomen (43.6%). The following variables were associated with bacterial infection in univariate analysis: younger age (5.6 vs 8.9 years old), longer duration of JP Drain (13.4 vs 6.3 days), central venous catheter (14.6 vs 7.6 days), and Foley catheter insertion (7.3 vs 4.5 days), reoperation (57% vs 12% of patients), mean frequency of reoperation (1.1 vs 0.1 times), and intensive care unit stay (12.1 vs 6.5 days). In multivariate analysis, only longer hospital stay after transplant (23.6 vs 10.9 days) was independently associated with bacterial infection. All ten deaths occurred within the infection group and half of which directly caused by infection. Conclusions: These infections were associated with longer hospital stay and higher mortality rate. Conducting further studies with larger sample size and investigating more effective prophylactic measures should be considered in future studies. [ABSTRACT FROM AUTHOR]

Introduction: A considerable proportion of patients with non-alcoholic fatty liver disease (NAFLD) will progress to non-alcoholic steatohepatitis (NASH) that may eventuate in liver cirrhosis. This study aimed to investigate the status and trend of NASH as an indication for liver transplantation in Iranian patients. Methods: The liver transplant data of all cirrhotic patients who had undergone liver transplantation or who died in transplant waiting list between 2004 and 2016 at Shiraz Organ Transplant Center, Shiraz, Iran were reviewed. The underlying liver diseases leading to liver transplantation were stratified according to year of transplantation and trend of increase or decline were calculated. Patients with cryptogenic liver cirrhosis with body mass index ≥ 30 kg/m2 was defined as modified NASH. Results: Totally 4666 patients with liver cirrhosis were evaluated. 3727 patients underwent liver transplantation and 939 patients passed away. 64 patients with biopsy proven NASH underwent liver transplantation at our center and 27 patients died in waiting list. Mean age and model for end stage liver disease (MELD) were not statistically significant in patients with NASH and modified NASH (P > 0.05). The prevalence of NASH as an indication for liver transplantation in 2011 was 0.59%, in 2012 was 1.05%, in 2013 was 1.45%, in 2014 was 3.8%, in 2015 was 2.7% and in 2016 was 5.65%. The prevalence of modified NASH was 2.08% in 2011, 1.81% in 2012, 2.34% in 2013, 1.97% in 2014, 1.89% in 2015, and 1.86% in 2016. Using Kaplan-Meier curve, mean post-liver transplant survival was 42.38 ± 2.35 months in NASH patients and 47.71 ± 2.98 in modified NASH patients (P = 0.558). Conclusion: This is the largest report of patients with liver cirrhosis showing NASH is a rapidly growing cause of liver cirrhosis and liver transplantation in Iranian patients. [ABSTRACT FROM AUTHOR]

Background: Hepatic steatosis is an increasing complication in liver transplant recipients. Currently, there is no pharmacologic therapy for treatment of hepatic steatosis after liver transplantation. The aim of this study was to determine the association between use of angiotensin receptor blockers (ARB) and hepatic steatosis in liver transplant recipients. Methods: We conducted a case-control analysis on data from Shiraz Liver Transplant Registry. Liver transplant recipients with and without hepatic steatosis were compared for risk factors including use of ARB. Results: A total of 103 liver transplant recipients were included in the study. Thirty five patients treated with ARB and 68 patients (66%) did not receive these medications. In univariate analysis, ARB use (P = 0.002), serum triglyceride (P = 0.006), weight after liver transplantation (P = 0.011) and etiology of liver disease (P = 0.008) were associated with hepatic steatosis after liver transplantation. In multivariate regression analysis, ARB use was associated with lower likelihood of hepatic steatosis in liver transplant recipients (OR = 0.303, 95% CI: 0.117–0.784; P = 0.014). Mean duration of ARB use (P = 0.024) and mean cumulative daily dose of ARB (P = 0.015) were significantly lower in patients with hepatic steatosis. Conclusion: Our study showed that ARB use was associated with reduced incidence of hepatic steatosis in liver transplant recipients. [ABSTRACT FROM AUTHOR]

Letters to the editor and a reply are presented in response to the article "Euthanasia, terminal illness and quality of life," by T. Nayernouri in the 2011 issue.

Background: Genetic abnormalities might have important role in pathogenesis of hepatic steatosis after liver transplantation. We aimed to investigate association between genetic variations in transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, proprotein convertase subtilisin/kexin type 9 (PCSK9) rs505151 and proprotein convertase subtilisin/kexin type 7 (PCSK7) rs2277287 with hepatic steatosis in liver transplant recipients.Methods: In a cross-sectional study, adult (> 18 years) liver transplant recipients who were referred for their routine post-transplant follow-up between June 2018 and September 2018 were included in the study. Hepatic steatosis in transplant recipients was assessed by controlled attenuation parameter (CAP). Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to study TM6SF2 rs58542926, PCSK7 rs2277287 and PCSK9 rs505151 genotypes.Results: 107 liver transplant recipients were included. There was no association between different genotypes of PCSK9 rs505151 and PCSK7 rs2277287 with hepatic steatosis in liver transplant recipients (P value > 0.05). The presence of TT genotype of TM6SF2 rs58542926 was higher in patients with hepatic steatosis measured by CAP after liver transplantation. In patients with moderate and severe hepatic steatosis (grade 2 and 3 steatosis), AG + GG genotypes of PCSK9 rs505151 were more prevalent than AA genotype (OR 8.667; 95% CI 1.841-40.879; P value = 0.004) compared to patients with mild steatosis (grade 1). In multivariate regression model, AG + GG genotypes of PCSK9 rs505151 were associated with moderate and severe steatosis in liver transplant recipients (OR 5.747; 95% CI 1.086-30.303; P value = 0.040).Conclusions: Genetic variations in TM6SF2 rs58542926 and PCSK9 rs505151 might be associated with hepatic steatosis in liver transplant recipients. [ABSTRACT FROM AUTHOR]

Background: Progressive familial intrahepatic cholestasis is a disease presenting with severe cholestasis and progressing to the end-stage liver disease later. Liver transplantation is a treatment modality available for progressive familial intrahepatic cholestasis, especially in patients with end-stage liver disease or those who are unsuitable for or have failed biliary diversion. Objectives: To evaluate clinical and pathological characteristics of progressive familial intrahepatic cholestasis patients who had undergone liver transplantation and to determine post-transplant steatosis and steatohepatitis. Methods: We evaluated 111 progressive familial intrahepatic cholestasis patients with normal gamma-glutamyl transferase that performed liver transplantation in Shiraz Transplant Center in Iran between March 2000 and March 2017. Results: The most common clinical manifestations were jaundice and pruritus. Growth retardation and diarrhea were detected in 76.6% and 42.5% of the patients. After transplantation, growth retardation was seen in 31.5% of the patients, and diarrhea in 36.9% of them. Besides, 29.1% of the patients died post-transplant. Post-transplant liver biopsies were taken from 50 patients, and 15 (30%) patients had steatosis or steatohepatitis, five of whom (10%) had macrovesicular steatosis alone, and 10 (20%) had steatohepatitis. Only one patient showed moderate bridging fibrosis (stage III), and none of them showed severe fibrosis. Conclusions: Liver transplantation is the final treatment option for these patients, and it can relieve most clinical manifestations. However, post-transplant mortality rate was relatively high in our center. Diarrhea, growth retardation, and steatosis are unique post-transplant complications in these patients. The rate of post-transplant steatosis and steatohepatitis in patients with liver biopsy in our study was 30%, with a significant difference from previous studies. [ABSTRACT FROM AUTHOR]

Our data about pathogenesis of hepatic steatosis after liver transplantation is scarce. This study aimed to investigate the association between serum adipokines and insulin resistance with hepatic steatosis in liver transplant recipients. We investigated the association between insulin resistance, serum adiponectin, insulin, and leptin with hepatic steatosis in a cohort of liver transplant recipients. Homeostatic model assessment of insulin resistance 2 (HOMA 2-IR) was used for estimation of insulin resistance. Hepatic steatosis was determined using ultrasound and controlled attenuation parameter (CAP). A total of 178 patients were included. 79 patients (44.4%) had hepatic steatosis. Serum adiponectin (OR: 0.912; 95% CI 0.869–0.957; P < 0.001), serum leptin (OR: 1.060; 95% CI 1.017–1.102; P = 0.005), HOMA2-IR (OR: 1.671; 95% CI 1.049–2.662; P = 0.031), and post-transplant diabetes mellitus (PTDM) (OR: 5.988; 95% CI 1.680–21.276; P = 0.006) were independently associated with hepatic steatosis after liver transplantation. CAP values were negatively correlated with serum adiponectin (P = 0.011) and positively correlated with serum insulin (P = 0.001), leptin (P < 0.001) and HOMA2-IR (P < 0.001). Insulin resistance and alterations in adipokines might have central role in pathogenesis of hepatic steatosis after liver transplantation and can be targeted for diagnostic and therapeutic purposes. [ABSTRACT FROM AUTHOR]

• An increasing proportion of patients are being transplanted for non-alcoholic steatohepatitis (NASH) in Europe. • Hepatocellular carcinoma was more common in patients transplanted with NASH. • Survival in recipients with NASH is comparable to that of other disease indications. • Age, BMI, and advanced liver disease predicted poorer outcomes in NASH recipients. Little is known about outcomes of liver transplantation for patients with non-alcoholic steatohepatitis (NASH). We aimed to determine the frequency and outcomes of liver transplantation for patients with NASH in Europe and identify prognostic factors. We analysed data from patients transplanted for end-stage liver disease between January 2002 and December 2016 using the European Liver Transplant Registry database. We compared data between patients with NASH versus other aetiologies. The principle endpoints were patient and overall allograft survival. Among 68,950 adults undergoing first liver transplantation, 4.0% were transplanted for NASH – an increase from 1.2% in 2002 to 8.4% in 2016. A greater proportion of patients transplanted for NASH (39.1%) had hepatocellular carcinoma (HCC) than non-NASH patients (28.9%, p < 0.001). NASH was not significantly associated with survival of patients (hazard ratio [HR] 1.02, p = 0.713) or grafts (HR 0.99; p = 0.815) after accounting for available recipient and donor variables. Infection (24.0%) and cardio/cerebrovascular complications (5.3%) were the commonest causes of death in patients with NASH without HCC. Increasing recipient age (61–65 years: HR 2.07, p < 0.001; >65: HR 1.72, p = 0.017), elevated model for end-stage liver disease score (>23: HR 1.48, p = 0.048) and low (<18.5 kg/m2: HR 4.29, p = 0.048) or high (>40 kg/m2: HR 1.96, p = 0.012) recipient body mass index independently predicted death in patients transplanted for NASH without HCC. Data must be interpreted in the context of absent recognised confounders, such as pre-morbid metabolic risk factors. The number and proportion of liver transplants performed for NASH in Europe has increased from 2002 through 2016. HCC was more common in patients transplanted with NASH. Survival of patients and grafts in patients with NASH is comparable to that of other disease indications. The prevalence of non-alcoholic fatty liver disease has increased dramatically in parallel with the worldwide increase in obesity and diabetes. Its progressive form, non-alcoholic steatohepatitis, is a growing indication for liver transplantation in Europe, with good overall outcomes reported. However, careful risk factor assessment is required to maintain favourable post-transplant outcomes in patients with non-alcoholic steatohepatitis. [ABSTRACT FROM AUTHOR]

Background: Most pancreatic masses are primary ductal adenocarcinomas; however, with the advent of new imaging studies and increasing survival of cancer patients, there are more cases with the diagnosis of secondary metastatic cancer to the pancreas. There is no study regarding cancer metastases to the pancreas from Iran. In this study, we retrieved all of the cases with the diagnosis of secondary cancer of pancreas in the affiliated hospitals of Shiraz University of Medical Sciences. Methods: In 5 years (2012-2017), we evaluated all cases with the diagnosis of any pancreatic tumors and extracted all of the demographic and clinicopathologic findings of the cases with the diagnosis of metastatic pancreatic tumors from the clinical charts and pathology reports. Results: For the duration of 5 years in our center, there were 131 cases of pancreatic tumors with different diagnoses, 9 of which were diagnosed as metastatic cancers from other organs. Two cases were diagnosed with gastric adenocarcinoma, 2 cases were colonic adenocarcinoma, one case was lung small cell carcinoma, 2 cases were renal cell carcinoma (RCC) and one case was gastrointestinal stromal tumor (GIST). The mesenchymal metastatic cancer to the pancreas has been a case of pleomorphic sarcoma of retroperitoneum. Conclusion: Pancreas is not a common location for metastases; however, colon, stomach, kidney and lung seem to be the most common primary tumors with metastases to the pancreas. Our report is the first study about pancreatic metastatic tumors from Iran. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus remains a major cause of nosocomial infection worldwide. Characterization of S. aureus isolates circulating in the southwest of Iran will contribute to understand and control the spread of the strains in this area. spa and SCC mec typing methods were used for genotyping of 125 S. aureus isolates obtained from two teaching hospitals in Ahvaz. Drug susceptibility testing was performed by using disk diffusion method. Frequency of the methicillin resistant S. aureus (MRSA) isolates was 39% (n = 34) and 27% (n = 10) in Emam Khomeini and Golestan hospitals, respectively. Except for Erythromycin, MRSA strains showed high rate of resistance to antimicrobial agents including penicillin (100%), norfloxacine (80%), azitromycin (80%), ciprofloxacin (80%), gentamycin (77%), cotrimoxazole (75%), cephotaxime. All isolates were sensitive to vancomycin. Out of 44 MRSA strains, 39 (88.5%) were SCC mec III, three (7%) were IVc and two (4.5%) of them were nontypeable. spa types t037 (26 isolates; 59%), and t1149 (25 isolates; 31%) were the most dominant types found in MRSA and methicillin sensitive S. aureus (MSSA) strains, respectively. We found SCC mec type III as the most prominent type indicating that most of the studied bacterial population had hospital origin. spa type t037, the most frequent genotype in this study were significantly (100%) associated with MRSA. For the first time we are reporting spa types t692, t706 and t018 from Iran and t342, t704, t2622, t5598, t11270 and t2864 from Asia. Moreover we are reporting types t6871 and t2684 for the second time in the world. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus by producing biofilm and facilitating chronic infection is a common cause of mastitis in cows and thereby can cause food poisoning by production of enterotoxins in milk. The agr typing method is an important tool for epidemiological investigation about S. aureus . The aims of the present study were to detect biofilm related genes, 5 classical enterotoxin genes and the agr types among S. aureus isolates. The ability of S. aureus isolates to produce biofilm was evaluated by modified CRA plate. Six biofilm related adhesion genes ( ica D, ica A, fnb A, bap , clf A and cna ), five classical enterotoxin genes ( sea, seb, sec , sed and see ) and tst -1 gene were detected by PCR methods. Multiplex-PCR was used to determination of the agr groups. 55 out of 80(68.8%) S. aureus isolates were biofilm producer. The ica D gene was detected in 70 (87.5%) of isolates. The prevalence rates of fnb A, ica A, clf A, cna and bap were 72.5, 56.25, 50, 22.5, and 5% respectively. The agr group I and III were detected in 57.5% 25% of studied isolates. The sea , sed and tst -1 genes were found in 10%, 7.5% and 1.25% of isolates respectively. The majority of S. aureus were able to produce biofilm. Significant associations were observed between presence of the ica D, ica A, fnb A, clf A and the cna genes as well as biofilm formation. The present study revealed that isolates with the agr type III are more potent for biofilm production. Our data supported a possible link between the agr types and certain SE genes. [ABSTRACT FROM AUTHOR]

Introduction. Urinary tract infection (UTI) is common after pediatric kidney transplantation. The purpose of this study was to evaluate the prevalence of UTI and its risk factors in children and adolescents with kidney transplantation in Shiraz Transplant Center. Materials and Methods. All children with kidney transplantation from 1990 to 2008 who were under regular follow-up were included in this retrospective study. Confirmed episodes of UTI after the 1st month of kidney transplantation were reviewed. Results. Of the 216 patients younger than 19 years at the time of transplantation, 138 were included. The mean age at the time of kidney transplantation was 13.6 ± 3.5 years. Urinary tract infection was documented in 24 patients (15 girls and 9 boys), of whom 12 experienced 1 episode, 4 had 2 episodes, and 8 had more than 2 episodes, during a median follow-up period of 54 months. Of the patients with UTI, 14 (58%) had urinary reflux-obstruction disorders as the primary kidney diseases, 6 (25%) had suffered hereditary diseases, 3 (12.5%) had glomerular disease, and 1 (4.5%) had a urinary calculus. Occurrence of UTI was not significantly different among children with different primary kidney diseases (P = .22). Despite using prophylactic antibiotics after the 1st month of kidney transplantation in all 5 patients with neurogenic bladder, they all experienced recurrent UTI. Conclusions. Despite discontinuation of antibiotic therapy, UTI was uncommon in children after the first month of transplantation. Two significant risk factors for UTI were female gender and neurogenic bladder in this transplant population. [ABSTRACT FROM AUTHOR]

Background: Cirrhosis, the end stage of progressive hepatic fibrosis, is characterized by distortion of the hepatic architecture and the formation of regenerative nodules. Liver transplantation is one of the few available therapies for such patients. However, due to a severe shortage of organ donors, surgical complications, transplant rejection and the high cost of this procedure much interest has focused on research to find new treatment modalities for this disease. There is accumulating evidence for the contribution of bone marrow stem cells to participate in liver regeneration. Methods: Here we report on six patients with end stage liver disease who were subjected to intraportal administration of au- tologous bone marrow-derived CD133* in comparison to mononuclear cells in short-term (6 months) and long-term (24 months) follow up. Results: There were no adverse effects in any of the patients during the short- and long-term follow up period. Moreover, there were no significant alterations of liver function parameters, liver enzymes, serum albumin, creatinine, serum bilirubin and/or liver volume after transplantation of both types of autologous cells in these patients. Conclusion: Our study has shown both the safety and feasibility of this type of liver cell therapy and may be a bridge to liver transplantation. [ABSTRACT FROM AUTHOR]