Ultrasound-Guided Targeted Infusion of Autologous Bone Marrow-Derived Platelet-Rich Plasma (BMPRP) for the Treatment of Liver Cirrhosis Complicated with Type 2 Diabetes Mellitus

Qin Zhang, Xiong Gao, Yuanhuai Chen, Qiqiang Dong and Baochi Liu*

Background and Aim: Liver cirrhosis and type 2 diabetes mellitus (T2DM) mutually reinforce each other, creating a vicious cycle that accelerates disease progression. This study aimed to evaluate the efficacy and safety of ultrasound-guided targeted infusion of autologous bone marrow-derived platelet-rich plasma (BMPRP) in patients with cirrhosis complicated by T2DM.

Methods: In this multicenter retrospective cohort study, 50 patients from three medical centers between January 2023 and January 2024 were enrolled. The BMPRP group (n=30) received ultrasound-guided BMPRP infusion into the liver and pancreas in addition to conventional therapy, while the control group (n=20) received conventional hepatoprotective and hypoglycemic treatment only. Liver function (PT, ALB, TBIL, ascites volume) and glycemic parameters (FPG, HbA1c, insulin dosage, C-peptide) were compared at baseline and at 1, 3, 6, and 12 months after treatment. Longitudinal data were analyzed with linear mixed-effects models (LMMs) including fixed effects of group, time, and the group × time interaction, a patient-level random intercept, and adjustment for each outcome’s baseline value and age; between-group comparisons at the four post-baseline visits were adjusted for multiplicity using the Holm–Bonferroni procedure.

Results: Baseline characteristics were comparable between the two groups; given the small sample size, baseline values of each outcome were additionally included as covariates in the adjusted analyses. At 12 months, the BMPRP group showed significant improvements: PT was markedly shortened (15.17±1.12 vs. 18.37±1.59 s, P<0.001), ALB increased (39.37±3.16 vs. 32.57±4.38 g/L, P<0.001), TBIL decreased (18.50±5.45 vs. 31.80±9.42 μmol/L, P<0.001), and ascites resolved completely in 60% of patients (volume decreased from 1200.0±1323.5 to 233.3±583.3 mL, P<0.001). Glycemic control improved significantly: FPG decreased to 6.23±1.03 mmol/L (P<0.001), HbA1c to 6.22±0.70% (P<0.001), insulin dosage was reduced (7.60±9.06 vs. 23.93±18.93 U/d, P<0.001), and C-peptide increased (1.58±0.38 vs. 1.20±0.61 ng/mL, P<0.001). No significant improvement was observed in the control group. Adjusted LMM analyses confirmed significant group × time interactions for all eight outcomes (all P≤1.5×10⁻⁶); after Holm–Bonferroni adjustment, the BMPRP group was significantly superior to the control group for every outcome at months 6 and 12 (all adjusted P<0.001). BMPRP was well tolerated, with no treatment-related serious adverse events.

Conclusion: In this exploratory, non-randomized retrospective cohort study, ultrasound-guided dual-target (hepatic and pancreatic) BMPRP infusion was associated with sustained improvements in liver function and glycemic control, and with reduced insulin requirements, over 12 months in patients with cirrhosis complicated by T2DM, without treatment-related serious adverse events. These findings are hypothesis-generating and suggest that this dual-organ regenerative strategy is feasible; confirmation of its efficacy and safety requires adequately powered randomized controlled trials.

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Published on: Oct 8, 2026 Pages: 31-38

Full Text PDF Full Text HTML DOI: 10.17352/gjodms.000073
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