Evaluation of Liver Regeneration With Autologous Peripheral Stem Cells Transplantation in the Patient Needed Extensive Hepatectomy

1. Patients: 30 patients (10 patients in each 3 group)
2. Indication:

• Patients with Primary hepatocellular carcinoma combined liver cirrhosis (Hepatitis B, C, Non-B Non-C)
• Planned to right hepatectomy or extended right hepatectomy
• Patients who need right portal vein embolization due to insufficient expected remnant liver volume (< 40%) or severe hepatic dysfunction(ICGR15>10%)
• Child A classification
• ICG R15 < 25%
• Age : 20 - 70 years old
• Expected life period > 3months
• The patients who agreed to this study.

3. Contraindication

• Patients who planned liver transplantation
• Age <20 or >70 years old
• Pregnant women
• Patients on acute infection
• Acute hepatic failure
• Child class B or C
• Heart failure
• Existence of bleeding tendency : platelet < 30,000, INR > 2.2, Cr >2.5
• Patients who did not agree to this study.

4. Allocation: We will allocate patients randomly to three group including control group.
5. Methods

• Group 1: 4 days injection of G-CSF -> Plasma pheresis, Selection of CD34 cell -> Right portal vein embolization and infusion of CD34 cell into left portal vein.
• Group 2: 4 days injection of G-CSF -> Plasma pheresis -> Right portal vein embolization and infusion of mononuclear cell into left portal vein.
• Group 3 (control): Right portal vein embolization

( -> after 4 weeks, operation will be performed) 6. Evaluation: Change of liver volume, liver function test before and after portal vein embolization