Persistence of bilayered living-cell therapy donor DNA 10 months after application: a case report

Bilayered living-cell therapy has been shown in clinical trials to improve the rate of healing diabetic and venous leg ulcerations. However, literature is conflicted regarding the length of time living-cell therapy persists in acute and chronic wounds. An otherwise healthy 48-year-old man with sepsis from extensive lower-extremity wounds due to ecthyma gangrenosum was admitted to the hospital. Initial treatment consisted of surgical debridement, broad-spectrum antibiotics, and stabilization in the intensive care unit. After the patient was stabilized, three units of living-cell therapy meshed at a 3:1 ratio were applied to the wounds. Both wounds were healed after 20 weeks. Ten months post grafting, the patient returned with a recurrent ulcer in the area of graft placement. A biopsy of the wound for human leukocyte antigen revealed the presence of donor DNA from the bilayered living-cell therapy. This case suggests that bilayered living-cell therapy may persist for prolonged periods in patients without underlying skin disease or immunosuppression. Research to explicate the mode of action and optimal protocols for use of living-cell therapy is warranted.