Condition category
Nutritional, Metabolic, Endocrine
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr Laurent Spahr


Contact details

University Hospital of Geneva
Rue Micheli-du-Crest
+41 22 372 93 40

Additional identifiers

EudraCT number number

Protocol/serial number

Swissmedic 2008DR2031

Study information

Scientific title

Autologous human bone marrow stem cells mobilized by granulocyte colony-stimulating factor (G-CSF) to improve liver function in patients with decompensated alcoholic liver disease: a randomized study


Study hypothesis

Patients with advanced alcoholic liver disease often come to medical attention due to hepatic decompensation (fatigue, jaundice, ascites, bleeding and hepatic encephalopathy). The prognosis depends on the severity of the liver insufficiency. The characteristic features of patients who do not survive is profound liver failure and inability to achieve efficient parenchymal regeneration.

Study hypothesis:
The combination of stimulating autologous hematopoietic stem cells from the bone marrow after a 5-day mobilization course with G-CSF followed by a direct administration into the liver parenchyma via the hepatic artery translates into a better outcome during follow-up as compared to the standard care (which included only supportive measures).

Please note that as of 04/01/10 the anticipated end date for this trial has been extended from 31/03/10 to 31/12/10.

Ethics approval

Protocol N°07-145 approved by the local Ethics Committee (Comite Departemental D'Ethique de Médecine Interne et Médecine Communautaire, 24, Rue Micheli-du-Crest CH-1211 Geneve Switzerland) on November 6, 2007. Also approved by the national Swiss Agency for Therapeutic Products (2008DR2031) on February 7, 2008.

Study design

Single-center randomized controlled study, not blinded.

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

Not specified

Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Alcoholic liver disease


The participants will be randomly allocated to the two study arms in equal numbers by an independent person using the sealed envelope technique.

Intervention arm: Stem cell embolisation in the hepatic artery
Control arm: supportive measures only

The following tests will be carried out in both arms at baseline:
1. Liver biopsy
2. Computed tomography (CT) with volumetry
3. Physical examination
4. Blood sampling for cytokines (tumor necrosis factor [TNF], Interleukin-6 [IL6], alpha-fetoprotein [AFP], Hepatocyte Growth Factor [HGF], transforming growth factor [TGF]-beta)
5. Routine hematology and coagulation studies
6. Blood chemistry with liver function test (to measure the MELD score)

Control arm: Supportive measures according to the standard care.
The following will be carried out at Day 28 visit:
1. Repeat liver biopsy
2. Physical examination
3. CT with volumetry
4. Blood sampling (idem)

Day 60 and day 90 visits will include only physical examination and blood tests.

In the treatment arm: Five-day mobilization course with lenograstim (G-CSF) 10 mcg/kg subcutaneously per day, followed by a 40 to 60 ml bone marrow aspiration from the iliac crest. Then, CD34+ and mesenchymal cells will be isolated from the aspirate using a classical Ficoll density separation. Within 36 h of aspiration, the suspension of cells (an average of 0.5 x 10^8 cells) will be selectively embolized via arteriography into the right and left hepatic artery branches, so as to distribute CD34+ and mesenchymal cells in both lobes of the liver. Day 28, 60 and 90 visits will be similar to the control arm.

Intervention type



Not Specified

Drug names

granulocyte colony-stimulating factor (G-CSF)

Primary outcome measure

Improvement of liver function, as assessed by a decrease in the MELD score of >3 between baseline, Day 28, 60, and 90 follow-up visits.

Secondary outcome measures

1. Improvement in liver function as assessed by the following parameters at Day 28, 60, and 90:
1.1. Bilirubin
1.2. Albumin
1.3. Coagulation times
1.4. Presence or absence of ascites
1.5. Presence or absence of hepatic encephalopathy)
This will allow the calculation of the Child-Pugh's score
2. Mortality at 3 and 6 months
3. Evolution of serum markers of liver regeneration (AFP, HGF), inflammation (TNF, IL6) and fibrosis (TGF-beta)
4. Changes in liver histology at Day 28

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Age 18-75 years
2. Biopsy-proven alcoholic liver disease
3. Abnormal liver function with a Model for End-Stage Liver Disease (MELD) (assessment that include bilirubin, coagulation time and creatinine) score 10-26
4. Written informed consent

Participant type


Age group




Target number of participants


Participant exclusion criteria

1. Recent (10 days) infection or hemorrhage
2. Estimated survival <6 months
3. Coexistent HIV, hepatitis C virus (HCV), hepatitis B virus (HBV)
4. Portal vein obstruction
5. Documented hepatocellular carcinoma
6. Severe liver atrophy as defined by volumetry <0.6% body weight
7. Leucocytes >25g/L
8. Known hypersensitivity to G-CSF
9. Creatinine >150 µmol/L
10. Contraindication to arteriography
11. Clinically overt hepatic encephalopathy
12. Absence of written consent

Recruitment start date


Recruitment end date



Countries of recruitment


Trial participating centre

University Hospital of Geneva

Sponsor information


Foundation for Liver and Gut Studies (FLAGS) (Switzerland)

Sponsor details

Rue Adrien Lachenal

Sponsor type




Funder type


Funder name

Foundation for Liver and Gut Studies (FLAGS), a non profit organisation based in Geneva (Switzerland)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

University Hospital of Geneva (Hôpitaux Universaires de Genève; HUG) (Switzerland)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

1. 2013 results in

Publication citations

  1. Results

    Spahr L, Chalandon Y, Terraz S, Kindler V, Rubbia-Brandt L, Frossard JL, Breguet R, Lanthier N, Farina A, Passweg J, Becker CD, Hadengue A, Autologous bone marrow mononuclear cell transplantation in patients with decompensated alcoholic liver disease: a randomized controlled trial., PLoS ONE, 2013, 8, 1, e53719, doi: 10.1371/journal.pone.0053719.

Additional files

Editorial Notes