RESUMO
BACKGROUND:With the development of surgical techniques and endovascular treatment techniques, the therapeutic efficacy on arteriosclerosis obliterans of the lower limbs has been improved greatly. As the long-term prognosis is stil not clear, how to treat arteriosclerosis obliterans of the lower limbs is stil a problem for vascular surgery. OBJECTIVE:To observe the long-term clinical efficacy of autologous bone marrow stem cel transplantation in the treatment of arteriosclerosis obliterans of the lower limbs. METHODS:Thirty-nine patients with arteriosclerosis obliterans who had undergone autologous bone marrow mesenchymal stem cels (totaly 56 times of cel transplantation) from September 2007 to July 2013 were enroled in this study. As of February 2015, the folow-up time was 7.5 years. After treatment, regular telephone folow-up about limb pain, cold sensation, intermittent claudication distance, resting ankle-brachial index and limb ulcer size and depth was done annualy; at 1 year after treatment, limb arteriography and venous blood gas analysis were reviewed. RESULTS AND CONCLUSION: Of the enroled 39 patients, 4 patients were subjected to amputation because of poor efficacy, 2 patients died of acute myocardial infarction, and 2 patients died of not timely amputation. There were 31 patients who had been folowed up for over 3 years. After treatment, the resting ankle-brachial index and limb ulcer size and depth limb pain were both improved significantly. There were significant differences in 1-year limb blood oxygen partial pressure and oxygen saturation before and after treatment, and the postoperative number of capilaries also increased significantly. These findings indicate that autologous bone marrow stem cel transplantation is a safe treatment for arteriosclerosis obliterans of the lower limbs with better and stable long-term curative effects. This method is a good choice for patients who have poor blood vessels and poor efficacy of traditional methods.
RESUMO
BACKGROUND:There are most single-center studies about bone marrow stem cels applied to treat decompensated cirrhosis, but the therapeutic results are not ideal. It is possibly related to aging, physical weakness, poor bone marrow hematopoietic function, less available number of stem cels and feeble ability of regeneration and proliferation in liver cirrhosis patients. Umbilical cord mesenchymal stem cels are characterized of easy to obtain, wide source and weak immunogenicity. Co-transplantation of bone marrow stem cels and umbilical cord mesenchymal stem cels may improve the therapeutic effects on decompensated cirrhosis patients. OBJECTIVE:To investigate the efficacy and safety of co-transplantation of umbilical cord mesenchymal stem cels and bone marrow stem cels on decompensated cirrhosis.METHODS:Thirty-two decompensated cirrhosis patients were randomly divided into two groups: in stem cel group, 13 patients received co-transplantation of umbilical cord mesenchymal stem cels and bone marrow stem cels based on regular medical treatment; in control group, 19 patients only underwent the regular medical treatment. Al the patients were folow-up for 1 year. Alanine aminotransferase, albumin, total bilirubin, prothrombin time, Child-Pugh score and Model for End-Stage Liver Disease score, 1-year survival rate, Quality of Life score and adverse reactions related to stem cel therapy were observed and recorded in the two groups at 4, 12, 52 weeks after treatment. RESULTS AND CONCLUSION:At 4, 12, 52 weeks after treatment, improvements in the liver function, prothrombin time, Child-Pugh score and Model for End-Stage Liver Disease score were found in the two groups, but there was no difference between the two groups (P > 0.05). At 4 weeks after transplantation, the clinical symptoms and Quality of Life score in the stem cel group were significantly improved, which were better than those in the control group (P 0.05). In addition, the 1-year survival rate showed no difference between the two groups, and no severe adverse reactions related to stem cel therapy occurred during the folow-up. Co-transplantation of umbilical cord mesenchymal stem cels and bone marrow stem cels is safe and effective to improve the clinical symptoms of decompensated cirrhosis patients. However, further studies with larger samples are warranted to better clarify the co-transplantation effects.