title: Autologous peripheral blood stem cell transplantation to treat thromboangiitis obliterans: preliminary results.
abstract: OBJECTIVE
  To investigate the efficiency of autologous peripheral blood stem cell transplantation (APBSCT) to treat severe the lower limbs ischemia caused by thromboangiitis obliterans (TAO).
  
  
  METHODS
  From April 2007 to December 2014, a total of 64 patients with TAO (80 affected limbs) received APBSCT at our hospital. The treatment effect was evaluated by subjective indicators including pains and cold sensation of the affected limbs, combined with objective indicators including claudication distance, ankle brachial index (ABI), transcutaneous oxygen pressure (TcPO2) and skin temperature.
  
  
  RESULTS
  Five patients (with 5 affected limbs) suffered from necrosis below the middle of the leg 4 weeks after transplantation and received amputation. For the remaining 59 patients (75 affected limbs), pain and cold sensation of the affected limbs were improved with varying extent 3 months after transplantation; there were statistically significant differences in pain score and cold sensation score of the affected limbs before and after APBSCT (p<0.05). Claudication distance, ABI, TcPO2 and skin temperature were also improved. Claudication distance increased from 85.69 m ± 43.48 m to 36.5 ± 9.88 mmHg, and the skin temperature of the lower limbs increased from 27.70 °C ± 0.53 °C to 33.49 °C ± 0.60 °C. All four indicators were considerably improved after APBSCT (p<0.05). Arteriography was performed for 75 affected limbs in 59 patients 6 months after transplantation and found that new collateral vessels were formed in the affected limbs. No patients were complicated by retinal hyperplasia, malignant tumors, myocardial infarction and cerebral infarction during the follow-up examinations; no patients underwent symptom aggravation during 9-48 month follow-up (average, 28.5 months).
  
  
  CONCLUSIONS
  APBSCT is an easy, safe and reliable treatment for ischemia of lower limbs, especially for those with poor distal arterial outflow tract in the lower limbs that do not permit bridging.
authors.affiliation: Department of Vascular Surgery, The Fourth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China. gui_minzhang@163.com.
authors.forename: J
authors.initials: J
authors.lastname: Wan
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.forename: Z-H
authors.initials: ZH
authors.lastname: Ma
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.forename: Y-Q
authors.initials: YQ
authors.lastname: Liu
authors.forename: G-J
authors.initials: GJ
authors.lastname: Li
authors.forename: G-M
authors.initials: GM
authors.lastname: Zhang
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D016026:Bone Marrow Transplantation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D013919:Thromboangiitis Obliterans / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome