Impact of mesenchymal stem cells on the coagulation mechanism in patients with liver cirrhosis: A review and prospects

Cirrhosis, characterized by extensive liver fibrosis and architectural distortion, is commonly associated with coagulation disorders that increase the risk of both bleeding and thrombosis. Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic strategy for liver diseases, including cirrhosis, due to their regenerative and immunomodulatory properties. This review delves into the intricate relationship between MSCs and the coagulation system in cirrhotic patients, examining the impact on platelet dysfunction, coagulation factor synthesis, endothelial dysfunction, and fibrinolysis. The review highlights MSCs’ multilineage differentiation potential and their ability to secrete both pro- and anti-coagulant factors, which are crucial in the context of liver disease. Clinical and preclinical findings on the effects of MSC therapy on coagulation are reviewed, along with safety and risk assessments. This review highlights the promising potential of MSCs in alleviating cirrhosis-associated coagulopathy, while identifying key challenges that must be addressed to advance clinical translation. Further research is therefore warranted to elucidate the underlying mechanisms and to optimize therapeutic strategies for clinical application.