Study Of The Implantation Of Autologous Bone Marrow Stem Cells In The Treatment Of Severe Lower Extremities Ischemia

OBJECTIVE: To evaluate the safety, near and long-dated efficacy of autologous bone marrow stem cells implantation for the treatment of severe lower extremities ischemia.METHODS: From October 2003 to October 2004, there were 40 patients (35 male patients and 5 female patients) suffering from severe lower extremities ischemia treated in Union Hospital. The average age of the patients was 65 years old (range from 56 to 82 years old). They were divided into two groups of their own accord. Group 1 (20 patients with 24 limbs) underwent transplantation of autologous bone marrow stem cells. 200mL bone marrow blood was drawn from the patients'posterior superior iliac spine, and then it was centrifuged and purified. About 100mL centrifugate with bone marrow mononuclear cells was left and injected into the skeletal muscle of the ischemic legs. After the operation, group 1 received conventional therapies also. Group 2 (20 patients with 26 limbs) received conventional therapies only. After one year's follow-up, the efficacy of the two methods was compared.RESULTS: During one year's follow-up, two patients of group 1 and three patients of group 2 were lost contact with. The total relieved rate of the symptom of the two groups was 81.8% (18/22) and 52.2% (12/23) respectively, P<0.05. The relieved rate of the feeling of pain an cold were 77.3%(17/22) and 43.5%(10/23), P<0.05; 68.2%(15/22) and 39.1%(9/23),P<0.05. The rate of amputation was 22.7%(5/22) and 39.1%(9/23), P>0.05. The total relieved rate of ABI was 63.6%(14/22) and 39.1%(9/23), P<0.05. Before the operation transcutaneous oxygen pressure was measured of each patient and the average value of the two groups were 27mmHg and 26mmHg. After one month's follow-up, the average transcutaneous oxygen pressure of the two groups were 40mmHg and 28mmHg, and after one year's follow-up were 42mmHg and 25mmHg. Five patients of the group 1 received arteriography before and one year after the operation, four of whose collateral circulation were increased remarkable and the diameter of some arteries increased.CONCLUSION: Transplantation of autologous bone marrow stem cells is a kind of effective and safe treatment for severe lower extremities ischemia. The result of one year's follow-up indicates that it can improve the symptom, avoid amputation, and its efficacy is superior to the routine treatment.