Therapeutic efficacy and in vivo distribution of human umbilical cord-derived mesenchymal stem cell spheroids transplanted via B-Ultrasound-guided percutaneous portal vein puncture in rhesus monkey models of liver fibrosis

• hUC-MSC spheroids transplanted via portal vein significantly restored liver function in rhesus monkey models of liver fibrosis, as evidenced by improved ALT, AST, ALB, GLOB, and bilirubin levels. • The treatment markedly reduced collagen deposition and inflammatory infiltration in the liver, indicating anti-fibrotic and anti-inflammatory effects. • Portal vein transplantation of MSC spheroids offers a minimally invasive delivery route that enhances liver targeting and retention compared to traditional intravenous infusion. • Transcriptome and RNA scope analyses provided insights into the molecular mechanisms and in vivo distribution of transplanted MSC spheroids, supporting their therapeutic potential.