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Advancements in Mesenchymal Stem Cell-Based Therapy for Enhancing Arteriovenous Fistula Patency
Gaurav Baranwal1, Haseeb Mukhtar1, Jamie Kane1
1Vascular and Interventional Radiology Translational Laboratory, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Insights
Mesenchymal stem cell therapy shows promise for improving arteriovenous fistula (AVF) patency in hemodialysis patients. This regenerative approach offers a potential alternative to current therapies for AVF failure, a common complication in chronic kidney disease (CKD).
Area of Science:
- Regenerative medicine
- Vascular biology
- Nephrology
Background:
- Chronic kidney disease (CKD) affects over 10% of the global population, necessitating renal replacement therapies like hemodialysis.
- Hemodialysis requires vascular access, typically an arteriovenous fistula (AVF) or arteriovenous graft (AVG).
- High rates of AVF failure (40% within the first year) necessitate interventions to maintain long-term patency.
Purpose of the Study:
- To review preclinical and clinical studies on mesenchymal stem cells (MSCs) for vascular regenerative medicine.
- To explore the potential of MSC-based therapies to enhance AVF patency and address AVF failure.
- To investigate MSCs as an alternative approach for improving hemodialysis vascular access.
Main Methods:
- Review of existing preclinical and clinical research on MSCs in vascular regenerative medicine.
- Analysis of studies utilizing fetal and adult mesenchymal stem cells from various sources.
- Focus on MSC applications aimed at improving AVF patency and function.
Main Results:
- Mesenchymal stem cells (MSCs) are being investigated for their regenerative potential in vascular applications.
- Different types of MSCs (fetal and adult) show promise in preclinical and clinical studies.
- MSC therapy presents a potential alternative strategy for enhancing AVF patency.
Conclusions:
- Mesenchymal stem cell therapy is a promising regenerative approach for improving arteriovenous fistula patency.
- This therapy offers a potential alternative to existing treatments for AVF failure in hemodialysis patients.
- Further research into MSCs could lead to improved vascular access outcomes for chronic kidney disease patients.
Abstract:
Chronic kidney disease (CKD) affects more than 10% of the world's population. Hemodialysis, along with peritoneal dialysis and renal transplant, is one of the renal replacement therapies offered to patients with CKD/end-stage renal disease (ESRD). To proceed with hemodialysis, vascular access is required. The two means of long-term access are arteriovenous fistula (AVF) and arteriovenous graft (AVG). Multiple therapies have been created to help the long-term patency of AVFs. These therapies are needed as 40% of AVFs fail within the first year and additional intervention is required. Much of the existing research has focused on biomarkers, immune cells, hypoxia, and cell-based therapies. Regeneration therapy using mesenchymal stem cells seeks to investigate other ways that we can treat AVF failure. Mesenchymal stem cells are harvested as two main types, fetal and adult. Fetal cells are harvested at different times in fetal gestation and from multiple sources, placental blood, Whartons jelly, and amniotic stem cell fluid. Taken together, this review summarizes the different preclinical/clinical studies conducted using different types of MSCs towards vascular regenerative medicine and further highlights its potential to be a suitable alternative approach to enhance AVF patency.
