Abstract: Objective The aim of this study was to investigate the efficacy of human umbilical cord-derived mesenchymal stem cell (UC-MSCs)transplantation at base of double plasma molecular absorption system (DPMAS) in the treamtment of patients with acute-on-chronic liver failure(ACLF). Methods 45 patients with ACLF were recruited in this study from January 2016 through May 2019, and 20 patients were treated with DPMAS for the control and 25 received UC-MSC transplantation at base of DPMAS. All patients were followed-up for eight weeks. Serum interleukin 6 (IL-6), IL-10 and tumor necrosis factor -α(TNF-α) were detected by ELISA, and peripheral blood lymphocyte subsets were tested by FCM. Results At the end of 8 week of treatment, serum bilirubin level in the cell transplanted group was (43.3±14.5)μmol/L and the model for end-stage liver disease score was (16.8±4.1), both significantly lower than 【(56.6±10.5)μmol/L and (20.6±4.8), respectively, P＜0.05】, while serum albumin level was (32.1±6.8)g/L, the PTA was (57.9±5.3)%, both significantly higher than 【(27.2±7.3)g/L and (53.8±5.5)%, P＜0.05】 in the control; the percentage of peripheral blood CD3⁺CD8⁺T cells was (13.1±2.5)%, much lower than 【(17.1±3.3)%, P＜0.05】, while that of CD3⁺T cells was (63.1±3.1)%, significantly higher than 【(59.7±4.2)%, P＜0.05】, and of CD3⁺CD4⁺T cells was (39.1±4.3)%, significantly higher than 【(34.9±4.1)%, P＜0.05】 in the control; serum TNF-α level was (7.1±4.3)ng/L, significantly lower than 【(11.2±5.2)ng/L, P＜0.05】 and serum IL-6 was (8.4±2.7)ng/L, much lower than 【13.2±3.2)ng/L, P＜0.05】 in the control; the survival rate in the control was 60.0%, much lower than 88.0% (P＜0.05) in cell transplanted group. Conclusion UC-MSC transplantation at base of DPMAS in the treatment of patients with ACLF has a good short-term efficacy, and its long-term impact on outcomes should be followed-up.

Key words: Acute-on-chronic liver failure, Umbilical cord-derived mesenchymal stem cells, Double plasma molecular absorption system, Efficacy