Regenerative Macrophage Cell Therapy Reduced Transplant Need in Liver Disease

Patients with the condition who were treated with the cell therapy had a significantly lower risk of death or need for a liver transplant after four years compared with those who received standard medical care.

Experts say the treatment offers a potential alternative to liver transplants for those in end-stage liver disease, which is currently the only curative treatment option but limited by donor availability, cost, and suitability for only a small subset of patients.

The liver has the unique ability to regenerate itself after damage. However, in patients with advanced liver disease, severe scarring – known as cirrhosis – can leave it damaged beyond repair, leading to liver failure.

Pioneering therapy

More than three-quarters of people are diagnosed with cirrhosis when it is too late for effective treatment, contributing to more than 11,000 deaths per year in the UK.

Scientists at the University of Edinburgh have developed a pioneering cell therapy designed to tackle the scarred tissue and restore liver function.

The treatment involves taking immune cells from the patients’ blood and turning them into mature macrophages - a type of white blood cell that ‘eats’ infected or damaged cells - which are then re-injected back into the patient.

The macrophages travel to the liver, where they break down scar tissue, reduce harmful inflammation, and encourage the growth of healthy liver cells.

Trial success

The treatment was tested in the MATCH clinical trial, with 26 patients receiving the macrophage therapy, while 24 received standard care.

After four years, 70 per cent of patients who received the macrophage therapy were living without the need for a liver transplant, compared with just 40 per cent of patients who did not receive the treatment.

There were eight deaths and no liver transplants among the patients treated with macrophages, compared with nine deaths and five liver transplants among those who received standard care. No serious side-effects were reported in patients treated with the cell therapy.

The four-year follow-up period provides important insights into the long-term benefits and safety of the treatment, according to the research team.

The findings suggest the use of macrophage therapy is a promising therapeutic option for end-stage liver disease and represents a significant step forward in regenerative medicine, experts say.

Collaborative effort

The macrophage therapy was developed following more than a decade of research by the University of Edinburgh’s Professor Stuart Forbes, alongside the Scottish National Blood Transfusion Service (SNBTS).

In 2020, Professor Forbes co-founded spinout company Resolution Therapeutics, with the support of Edinburgh Innovations, the University’s commercialisation service, to bring the team’s pioneering science to patients. The company is currently testing a new version of the macrophage therapy, known as RTX001, in patients through the EMERALD clinical trial.

Reference: Brennan PN, Kilpatrick AM, Glover A, et al. Autologous macrophage therapy increases transplant-free survival in cirrhosis: Long-term follow-up of a phase 2 clinical trial. Cell Stem Cell. 2026. doi: 10.1016/j.stem.2026.04.016

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