Autologous transplantation of peripheral blood mononuclear cells for the treatment of lower limb ischemia / 中国普通外科杂志

ABSTRACT

Objective To investigate the effect and safety of autologous transplantation of peripheral blood mononuclear cells (PBMCs) for the treatment of lower limb ischemia. Methods Eighty-three limbs in 53 patients with lower limb ischemia were treated by autologous transplantation of peripheral blood mononuclear cells from June 2004 to October 2005. Of the patients, there were 71 diabetic ischemic limbs in 44 cases, 6 arteriosclerotic occlusion limbs in 5 cases and 6 thromboangiitis obliterans in 4 cases. Symptoms included a feeling of pain in 80. 7% (67/83) limbs, cold in 72.3% (60/83) limbs and numb in 67.5% (56/83) limbs. Results There was no mortality. The outcome was evaluated after 2 months of transplantation. The pain-relieve rate, improvement rate of cold feeling and numbness was 83. 6% , 91. 7% and 75. 0% , respectively. Ankle / brachial index ( ABI) increased in 39. 8% (33/83) limbs. TcPO2 of the ischemic legs was obviously elevated in 89. 2% (74/83 ) limbs. Ulceration area reduced in 29. 2% limbs. Digital subtraction angiography ( DSA) was performed in 44. 6% (37 limbs of 23 patients) with collateral circulation increased in 72. 9% limbs. 15 limbs (18. 1% ) were amputated including 5 limbs with lowered level of amputation. Conclusion Autologous transplantation of peripheral blood mononuclear cells is a simple, safe, and effective method to treat patients with lower limb ischemia in which arterial reconstruction is impossible.