G-CSF and Erythropoetin in Survival of Patients With Decompensated Liver Disease
G-CSF and Erythropoetin in Survival of Patients With Decompensated Liver Disease
Study Design

 50 patients will be enrolled and randomized into patients (Group IA) and controls (Group I B)

 Investigations:

 Hematology CBC, Prothrombin time and INR Peripheral smear, Retics Biochemistry Liver function
 testing, AFP Kidney function testing Etiology of chronic liver disease Infectious etiology:
 total antiHBc, anti HCV, HCV RNA, HBV DNA Non infectious etiology: Autoimmune markers, copper
 studies, iron studies, HOMA IR, FBS Etiology of decompensation Variceal bleed Infection (
 blood culture, urine culture, sputum culture, chest xray) Surgery Drugs Alcohol intake
 Ascitic fluid analysis UGI endoscopy Imaging USG abdomen with Doppler for spleno-portal axis
 CECT- Triple phase upper abdomen Liver regenerative potential efficacy testing Histology ( by
 transjugular liver biopsy) Liver Dendritic cells ( CD11c, CD40, CD 54, CD 123, BDCA 2
 staining) by flow cytometry CD 34+ cells, CD 45+ cells and CD 133+ cells measurement in
 hepatic venous blood, peripheral blood and liver biopsy by flow cytometry Markers of
 proliferation like Ki- 67, proliferating cell nuclear antigen (PCNA) in liver biopsy Markers
 of angiogenesis like VEGF, v WF in hepatic venous blood Measurement of Hepatic venous
 pressure gradient ( HVPG)
Inclusion Criteria:

 -  All patients who were known to have cirrhosis of liver with portal hypertension, now
 decompensated with ascites/ jaundice/ bleed/ HE/ HRS

 Exclusion Criteria:

 -  Age <12 or > 75 years

 -  Autoimmune disorders

 -  HCC

 -  Sepsis ( Any culture positive: blood, urine, any other obvious source of
 infection: UTI, SBP)

 -  Multi organ failure

 -  Grade 4 HE

 -  HIV seropositivity / pregnancy

 -  Essential Hypertension

 -  Patients being taken up for transplant

 -  Refusal to participate in the study