title: Prevention of limb amputation in patients with limbs ulcers by autologous peripheral blood mononuclear cell implantation.
abstract: There are many cases of amputation of ischemic limbs of dialysis patients due to diabetes, despite the availability of medicine therapy and vascular by-pass operations. As there is extensive ruin of the vascular bed due to diabetes, vascular regeneration therapy by stem cell implantation is effective. Thirty patients with ischemic limbs due to diabetes (not including type-I) and on dialysis for chronic renal failure (19 cases), diabetes (5 cases), dialysis patients without diabetes (4 cases), and arteriosclerosis obliterans (ASO, 2 cases) were treated by autologous peripheral blood stem cell (PBSC) implantation where imminent amputation was under consideration. Granulocyte Colony Stimulate Factor (G-CSF: 5 microg/kg/day) was administered subcutaneously for 4 days before PBSC collection, that was carried out using a centrifuge (Spectra and/or CS3000) via the vein. The collected PBSC, containing 4.2 x 10(7) of CD 34 positive cells, was divided into units of 0.5-1.0 mL and implanted, without any purification, to the ischemic area of the limbs in about 65 points. In 21 cases, normalization of limb temperature was observed by thermograph, and symptoms also improved. The result of this first attempt of PBSC implantation is that we were able to save 22 ischemic limbs. This is the first large report of the application of regenerative medicine to peripheral ischemic limbs.
authors.affiliation: Department of Surgery and Haematology, Sapporo Hokuyu Hospital, Sapporo 003-0006, Japan. ak17210@spa.att.ne.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Kawamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Horie
authors.forename: Ichirou
authors.initials: I
authors.lastname: Tsuda
authors.forename: Atushi
authors.initials: A
authors.lastname: Ikeda
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Egawa
authors.forename: Emi
authors.initials: E
authors.lastname: Imamura
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Iida
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sakata
authors.forename: Tohru
authors.initials: T
authors.lastname: Tamaki
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kukita
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Meguro
authors.forename: Motoki
authors.initials: M
authors.lastname: Yonekawa
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kasai
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D001781:Blood Component Removal; D016026:Bone Marrow Transplantation; D003924:Diabetes Mellitus, Type 2; D017719:Diabetic Foot / Q000628:therapy*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000628:therapy; D007866:Leg / Q000098:blood supply; D007871:Leg Ulcer / Q000628:therapy*; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D014182:Transplantation, Autologous