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Purpose:To prospectively evaluate the effectiveness of portal vein embolization (PVE)and CD133(+) bone marrow stem cell (BMSC) administration to the liver, comparedwith PVE alone, to augment hepatic regeneration in patients with large hepaticmalignancies. Materials and Methods: The study was approved by theinstitutional ethics committee; informed consent was obtained. Thirteenpatients underwent PVE of liver segments I and IV-VIII to stimulate hepaticregeneration prior to extended right hepatectomy. In six patients (three men,three women; mean age, 61 years; range, 46-72 years) with a future liverremnant volume (FLRV) below 25% and/or limited quality of hepatic parenchyma,PVE alone did not promise adequate proliferation. These patients underwent BMSCadministration to segments II and III (group I). In seven patients (three men,four women; mean age, 69 years; range, 63-75 years) with an FLRV below 25%, PVEalone was performed (group II). Two radiologists blinded to patients' identityand each other's results measured liver and tumor volumes with helical computedtomography. Absolute, relative, and daily FLRV gains were compared by using thet test or the Wilcoxon test. Results: The increase of the mean absolute FLRV ingroup I from 239.3 mL +/- 103.5 (standard deviation) to 417.1 mL +/- 150.4 wassignificantly higher than that from 286.3 mL +/- 77.1 to 395.9 mL +/- 94.1 ingroup II (P = .049). The relative gain of FLRV after PVE in group I (77.3% +/-38.2) was significantly higher than that in group II (39.1% +/- 20.4) (P =.039). The daily hepatic growth rate in group I (9.5 mL/d +/- 4.3) wassignificantly superior to that in group II (4.1 mL/d +/- 1.9) (P = .03). Timeto surgery was 27 days +/- 11 in group I and 45 days +/- 21 in group II (P =.057). Conclusion: In patients with malignant liver lesions, the combination ofPVE with CD133(+) BMSC administration substantially increased hepaticregeneration compared with PVE alone.Leggil'articolo