Тransplantation of autologous stem cells, obtained from adipose tissue, in complex treatment of chronic ischemia of the lower extremities


Keywords: mesenchymal stem cells; critical chronic ischemia of the lower extremities; laser duplex flowmetry; еlectro-welding of living tissues

Abstract

Objective. To investigate the efficacy of application of autologous mesenchymal stem cells (AMSC) in treatment of patients, suffering critical ischemia of the lower extremities (CILE).
Маterials and methods. In 2012 - 2015 yrs there was conducted the treatment of 41 patients, suffering CILE: 22 (53.7%) - men, and 19 (46.3%) - women. In the Group I (the main) 21 (51.2%) patients have had obtained a standard course of treatment, using AMSC. In the Group II (the control one) 20 (49.8%) patients have obtained a standard course of conservative treatment, using prostaglandins of group Е1 (PGЕ1). The results were investigated, measuring ankle-brachial pressure index, and the indices of a laser duplex flowmetry and a walking distance.

Results. During a one-year follow-up a trustworthy enhancement of microcirculation index was registered in the patients, who were treated, using AMSC, comparing with the patients, who obtained a course of therapy of PGЕ1 (р=0.037). Positive dynamics of the microcirculation index while a PGЕ1application was observed during (1.8 ± 0.3) mo, аnd while application of AMSC the microcirculation index have been enhanced trustworthily in (2.7 ± 0.4) mo and persisted during one-year of follow-up.

Conclusion. Development of therapeutic effect in groups of patients, who were treated with AMSC and PGЕ1, did not occur simultaneously, thus , a complex treatment with simultaneous application of both methods and conduction of a dosed physical training may be considered a rational option.

References

1. Fowkes FG, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott MM, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013 Oct 19;382(9901):1329-40. doi: 10.1016/S0140-6736(13)61249-0.

2. Hirsch AT, Duval S. The global pandemic of peripheral artery disease. Lancet. 2013 Oct 19;382(9901):1312-4. doi: 10.1016/S0140-6736(13)61576-7.

3. Litvinova N, Chernyak V, Dubenko D. Model formuvannya kontrolyovanoi ishemii nizhnyoi kintsivky u krolyka. Serce i sudyni. 2016;(4):61-5. [In Ukrainian].

4. Ho TK, Rajkumar V, Black DC, Abraham D, Baker D. Critical limb ischemia classification and therapeutic angiogenesis. Int J Angiol. 2005 May;14(2):49-59. doi:10.1007/s00547-005-2030-1.

5. Anker PS, Scherjon SA, Kleijburgvan der Keur C. Amniotic fluid as a novel source of mesenchymal stem cells for therapeutic transplantation. Blood. 2003 Aug 15;102(4):1548-49. doi: 10.1182/blood-2003-04-1291.

6. Blits B, Boer GJ, Verhaagen J. Pharmacological, cell, and gene therapy strategies to promote spinal cord regeneration. Cell Transp. 2002;11(6):593-613. PMID: 12428749.

7. Iba O, Matsubara H, Nozawa Y, Fujiyama S, Amano K, Mori Y, et al. Angiogenesis is by implantation of peripheral blood mononuclear cells and platelets into ischemic limbs. Circulation. 2002 Oct 8;106(15):2019-25. doi:10.5361/jkmu1956.56.2-4_194.

8. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007 Jan;45 Suppl S:S5-67. doi: 10.1016/j.jvs.2006.12.037.

9. Idei N. Autologous bone-marrow mononuclear cell implantation reduces long-term major amputation risk in patients with critical limb ischemia: a comparison of atherosclerotic peripheral arterial disease and Buerger disease. Circ Cardiovasc Interv. 2011 Feb 1;4(1):15-25. doi: 10.1161/CIRCINTERVENTIONS.110.955724.

10. Iafrati MD. Early results and lessons learned from a multicenter, randomized, double-blind trial of bone marrow aspirate concentrate in critical limb ischemia. J Vasc Surg. 2011;54(6):1650–8. doi: 10.1016/j.jvs.2011.06.118.

11. Walter DH, Krankenberg H, Balzer JO, Kalka C, Baumgartner I, Schlüter M, et al. Intraarterial administration of bone marrow mononuclear cells in patients with critical limb ischemia: a randomizedstart, placebo-controlled pilot trial (PROVASA). Circ Cardiovasc Interv. 2011 Feb 1;4(1):26–37. doi: 10.1161/CIRCINTERVENTIONS.110.958348.

12. Losordo DW, Kibbe MR, Mendelsohn F, Marston W, Driver VR, Sharafuddin M, et al. A randomized, controlled pilot study of autologous CD34+ cell therapy for critical limb ischemia. Circ Cardiovasc Interv. 2012 Dec;5(6):821-30. doi: 10.1161/CIRCINTERVENTIONS.112.968321.

Author Biographies


V. G. Mishalov, Bogomolets National Medical University, Kyiv

Volodymyr G. Mishalov, MD, D.Med.Sci professor, head of the department
Department of Surgery №4,

Bogomolets national medical university
01601, T. Shevchenko boulevard, 13, Kyiv, Ukraine.

Phone (044) 234-40-62. Telefax (044) 234-92-76

E-mail: Vladimir.mishalov@nmu.ua

ORCID: http://orcid.org/0000-0001-7263-7375


N. Yu. Litvinova, Bogomolets National Medical University, Kyiv

Natalia Yu. Litvinova, PhD, assistant professor

Department of Surgery №4,

Bogomolets national medical university

01601, T. Shevchenko boulevard, 13, Kyiv, Ukraine.
Phone (044) 234-40-62. Telefax (044) 234-92-76

E-mail: Nataliya.litvinova@nmu.ua
ORCID: http://orcid.org/0000-0002-5810-756X


O. I. Kefeli-Yanovska, Bogomolets National Medical University, Kyiv

Olena I. Kefeli-Yanovska, assistant

Department of Human Anatomy,

Bogomolets national medical university

01601, T. Shevchenko boulevard, 13, Kyiv, Ukraine.

Phone (044) 234-40-62. Telefax (044) 234-92-76

E-mail: Lena.Kefeli@nmu.ua

ORCID: https://orcid.org/0000-0003-1326-2424


V. A. Chernyak, Bogomolets National Medical University, Kyiv

Victor A. Chernyak, MD, D.Med.Sci, professor,

head of the Department of operative surgery and topographic anatomy,

Bogomolets national medical university

01601, T. Shevchenko boulevard, 13, Kyiv, Ukraine.

Phone (044) 234-40-62. Telefax (044) 234-92-76

E-mail: victor.chernyak@nmu.ua

ORCID: http://orcid.org/0000-0001-8424-4691


D. E. Dubenko, Bogomolets National Medical University, Kyiv

Dmytro Ye. Dubenko, senior laboratory assistant,

Department of operative surgery and topographic anatomy,

Bogomolets national medical university

01601, T. Shevchenko boulevard, 13, Kyiv, Ukraine.

Phone (044) 234-40-62. Telefax (044) 234-92-76

E-mail: Dubenko.md@gmail.com

ORCID: http://orcid.org/0000-0002-3016-0799


E. A. Dzhalilova, Danylo Galytsky Lviv National Medical University

Elvira A. Dzhalilova, assistant

Department of normal Anatomy,

Danylo Halytsky Lviv national medical university

79010, Pekarska st 69, Lviv, Ukraine

Phone +38 (032) 275-76-32 

E-mail: kaf_normanatomy@meduniv.lviv.ua

ORCID: https://orcid.org/0000-0001-7745-3663


O. I. Azarov, Bogomolets National Medical University, Kyiv

Olexander І. Azarov assistant

Department of Human Anatomy,

Bogomolets national medical university

01601, T. Shevchenko boulevard, 13, Kyiv, Ukraine.

Phone (044) 234-40-62. Telefax (044) 234-92-76

E-mail: alexandr.azarov@nmu.ua

ORCID:  https://orcid.org/0000-0001-7089-0115

Rostislav F. Kaminsky

Department of Human Anatomy,

Bogomolets national medical university

01601, T. Shevchenko boulevard, 13, Kyiv, Ukraine.

Phone (044) 234-40-62. Telefax (044) 234-92-76

ORCID: https://orcid.org/0000-0001-8656-5819

Published
2018-12-28
How to Cite
Mishalov, V. G., Litvinova, N. Y., Kefeli-Yanovska, O. I., Chernyak, V. A., Dubenko, D. E., Dzhalilova, E. A., Azarov, O. I., & Kaminsky, R. F. (2018). Тransplantation of autologous stem cells, obtained from adipose tissue, in complex treatment of chronic ischemia of the lower extremities. Klinicheskaia Khirurgiia, 85(12), 30-34. https://doi.org/10.26779/2522-1396.2018.12.30
Section
General Problems of Surgery

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