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Mesenchymal Stromal Cell Culture and Delivery in Autologous Conditions: A Smart Approach for Orthopedic Applications
Published on: December 8, 2016
Avoidance of lower-limb amputation by surgical implantation of autologous stem cells
K Blaire Kerwin1, Gregory J Pearl, Cris D Molina
1Soltero Cardiovascular Research Center (Kerwin, Molina, Coker, East), Baylor Heart and Vascular Hospital (Pearl, East), Dallas, Texas; and the Division of Cardiology, Department of Internal Medicine (Pearl, East), the Department of Oncology (Pineiro), and the Department of Cardiovascular Surgery (Urschel), Baylor University Medical Center at Dallas.
Insights
This study shows adult stem cell therapy effectively healed a nonhealing leg ulcer in a patient with critical limb ischemia. The treatment led to sustained ulcer healing and improved circulation for three years.
Area of Science:
- Regenerative Medicine
- Vascular Surgery
- Cell Therapy
Background:
- Critical limb ischemia (CLI) presents a significant challenge, often leading to nonhealing ulcers and amputation.
- Previous revascularization attempts failed for this patient with Rutherford stage 5 CLI.
- Autologous stem cell therapy is being explored as a novel treatment for CLI.
Purpose of the Study:
- To evaluate the efficacy of autologous stem cell therapy in treating critical limb ischemia with a nonhealing ulcer.
- To assess the impact of stem cell treatment on peripheral circulation and ulcer healing.
Main Methods:
- Harvesting autologous stem cells from the patient's pelvic bone marrow.
- Concentrating stem cells in the operating room.
- Reinjecting stem cells into the affected lower leg vasculature and around the ulcer.
Main Results:
- Significant improvement in ankle-brachial index (ABI) from 0.10 to 0.40 after 3 months.
- Early signs of ulcer healing observed at 3 months.
- Complete ulcer healing by 12 months, with sustained healing for 3 years.
Conclusions:
- Autologous stem cell therapy demonstrated promising results for treating critical limb ischemia.
- This approach offers a potential new avenue for healing chronic, nonhealing lower extremity ulcers.
- Sustained ulcer healing and improved vascularity were observed post-treatment.
Abstract:
A 69-year-old Caucasian man was referred to Baylor University Medical Center at Dallas with resting lower-extremity pain and a nonhealing sore above his right ankle (Rutherford chronic ischemia stage 5 of 6) after having failed multiple attempts at revascularization. He was enrolled in a clinical research trial using adult autologous stem cells for treatment of critical limb ischemia. Autologous stem cells from the patient's pelvic bone marrow were harvested, concentrated in the operating room, and reinjected into the lower leg along the vasculature below the level of complete occlusion of the popliteal artery and around the ulcer. After 3 months, the patient had significant improvement in his ankle brachial index, which increased from 0.10 to 0.40 (normal 0.9-1.01), and early healing. After 12 months, the ulcer was fully healed. Healing of the sore has persisted for 3 years.
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