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Administration of mesenchymal stem cells during ECMO results in a rapid decline in oxygenator performance

Jonathan Edward Millar1, Viktor von Bahr1,2, Maximillian V Malfertheiner1,3

  • 1Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia.

Thorax
|April 7, 2018
PubMed

Insights

Mesenchymal stem cells (MSCs) administered during extracorporeal membrane oxygenation (ECMO) may impair oxygenator function. This study shows MSCs reduce flow and increase pressure in ECMO circuits, highlighting potential risks for severe Acute Respiratory Distress Syndrome (ARDS) patients.

Area of Science:

  • Regenerative Medicine
  • Critical Care Medicine
  • Biomedical Engineering

Background:

  • Mesenchymal stem cells (MSCs) show promise for treating Acute Respiratory Distress Syndrome (ARDS).
  • Extracorporeal membrane oxygenation (ECMO) is increasingly used for severe ARDS.
  • Current MSC trials exclude patients on ECMO.

Purpose of the Study:

  • To investigate the impact of intravascular Mesenchymal stem cell (MSC) administration on membrane oxygenator function during extracorporeal membrane oxygenation (ECMO).
  • To assess potential adverse effects of combining MSC therapy with ECMO support in a simulated setting.

Main Methods:

  • An ex-vivo model simulating ECMO circuits was utilized.
  • Clinical grade MSCs were added to the ECMO circuit, and their effect on flow and pressure was measured.
  • Immunohistochemistry was performed to analyze MSC adhesion to the oxygenator fibers.

Main Results:

  • Addition of MSCs significantly reduced circuit flow (0.6 ±0.35 L/min vs 4.12 ± 0.03 L/min at 240 min).
  • MSCs caused a marked increase in the trans-oxygenator pressure gradient (101±9 mmHg vs 21±4 mmHg at 240 min).
  • Immunohistochemistry confirmed extensive MSC adherence to membrane oxygenator fibers.

Conclusions:

  • Intravascular administration of MSCs during ECMO may adversely affect membrane oxygenator function.
  • Potential risks include reduced circuit flow and increased pressure, necessitating further research.
  • This finding is critical for advancing cell therapy translation in ECMO-supported ARDS patients.
Keywords:
Ards

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