title: [Prognostic factors for critical limb ischemia after autologous bone marrow implantation].
abstract: OBJECTIVE
  Autologous bone marrow implantation (BMI) is effective to treat critical limb ischemia, but the long-term prognosis is not clear. The outcome of BMI treatment for ischemic legs was investigated related to the clinical background of the patient, and short-term effects of BMI. The end event was defined as unexpected lower limb amputation.
  
  
  RESULTS
  This study included 21 consecutive patients (mean age 60.0 +/- 13.6 years) with peripheral arterial disease who underwent BMI between December 2001 and March 2005. Twelve patients had arteriosclerosis obliterans (ASO), 5 had Buerger disease (thromboangiitis obliterans), 3 had thromboembolism, and 1 had hypereosinophilic syndrome. The patients with ASO had severe complications such as diabetes and hyperlipidemia. The total number of transplanted CD34-positive cells, ankle-brachial pressure index (ABI), and tissue oxygen pressure (TcO2) were lower in ASO patients than non-ASO patients. Significant risk factors for the event were diagnosis of ASO and low TcO2 (< 30 mmHg) according to the Kaplan-Meier survival curve and log rank test. All 6 patients who required limb amputation had ASO simultaneously with low TcO2 (6 of 9, 67%). In contrast, there was no correlation between the end event and short-term effect of BMI such as improvements in ABI and TcO2.
  
  
  CONCLUSIONS
  Treatment with BMI could not save legs in some patients with ASO associated with severe leg ischemia.
authors.affiliation: Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata. odamasato@pop01.odn.ne.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Oda
authors.forename: Kiminori
authors.initials: K
authors.lastname: Kato
authors.forename: Ken
authors.initials: K
authors.lastname: Toba
authors.forename: Keita
authors.initials: K
authors.lastname: Otaki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kitajima
authors.forename: Noboru
authors.initials: N
authors.lastname: Ikarashi
authors.forename: Takao
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Masutaka
authors.initials: M
authors.lastname: Higashimura
authors.forename: Fuyuki
authors.initials: F
authors.lastname: Asami
authors.forename: Manabu
authors.initials: M
authors.lastname: Isoda
authors.forename: Takuya
authors.initials: T
authors.lastname: Ozawa
authors.forename: Masato
authors.initials: M
authors.lastname: Moriyama
authors.forename: Satoru
authors.initials: S
authors.lastname: Hirono
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okura
authors.forename: Haruo
authors.initials: H
authors.lastname: Hanawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Kodama
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D000368:Aged; D000842:Ankle / Q000098:blood supply; D018952:Antigens, CD34; D001162:Arteriosclerosis Obliterans / Q000150:complications; D001785:Blood Gas Monitoring, Transcutaneous; D001794:Blood Pressure; D016026:Bone Marrow Transplantation; D001916:Brachial Artery / Q000502:physiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010313:Partial Pressure; D011379:Prognosis; D014182:Transplantation, Autologous
chemical_list: D018952:Antigens, CD34