Autologous Adipose-derived Stromal Stem Cell Implantation to Resolve Critical Limb Ischemia: Case Report

Parcero, J.; Perez, J.; Patel, Amit N.; Ichim, Thomas E.; González, Silvia Rodríguez; McQuillan, Sharon; Comella, Kristin; Lopez-Diaz, Mariano A; Castañeda, Carlos A.; Limon, Jose J.; López, Javier

doi:10.7759/cureus.182

Cited by 5 publications

(5 citation statements)

References 13 publications

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“… 13 This cluster of differentiation is part of the periendothelial network and is thought to be integral to the angiogenesis process. The use of SVF has been reported in a variety of indications including osteoarthritis, 14 – 16 degenerative disc disease, 17 sclerosis, 18 tendinopathy, 19 congestive heart failure, 20 chronic obstructive pulmonary disease, 21 radiation necrosis, 22 xerostomia, 23 and multiple sclerosis. 24 In addition, two studies have been published demonstrating the safety of SVF for a variety of indications used in a clinical outpatient setting.…”

Section: Introductionmentioning

confidence: 99%

First-in-man intravenous implantation of stromal vascular fraction in psoriasis: a case study

Comella¹,

Parlo²,

Daly³

et al. 2018

IMCRJ

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BackgroundStromal vascular fraction (SVF) is a mixture of adipose-derived stem cells/mesenchymal stem cells, endothelial/progenitors, pericytes, fibroblasts, and other cells obtained from fat tissue. A small sample of fat or adipose tissue can be obtained under local anesthesia using a cannula. After an enzymatic digestion and centrifugation, the adipocytes (fat cells) are removed to obtain an SVF. Here, we describe the rationale and, to our knowledge, the first clinical implementation of SVF intravenously in a patient with severe psoriasis.MethodsAdipose tissue (60 mL) was collected under local anesthesia via a mini-lipoaspirate procedure. The SVF was separated from the adipocytes via centrifugation after an enzymatic digestion. The cells were resuspended in normal saline and injected via bolus push intravenous. The subject was monitored over a period of 12 months for safety (adverse events), medication changes, and quality of life parameters.ResultsThe patient did not report any safety concerns and did not experience any severe adverse events. The patient demonstrated a significant decrease in symptoms with a noticeable difference in skin quality appearance. Psoriasis area and severity index score went from 50.4 at baseline to 0.3 at 1 month follow-up.ConclusionOverall, the patient reported improved quality of life and willingness to continue treatments. This successful initial case study demonstrates that this may be a feasible treatment plan for patients suffering from psoriasis.

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Section: Introductionmentioning

confidence: 99%

First-in-man intravenous implantation of stromal vascular fraction in psoriasis: a case study

Comella¹,

Parlo²,

Daly³

et al. 2018

IMCRJ

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“…SVF includes a cell population with greater than 50% CD34 expression and high viability (> 90%). The ADSCs isolated can also differentiate in culture into fat, bone and cartilage [27].…”

Section: Collection Of Adipose Tissue and Cell Populationmentioning

confidence: 99%

“…Fat tissue can be easily and safely harvested and SVF can be collected bedside making it an attractive therapeutic option for physicians to offer to their patients [19]. A variety of publications have reported on the injection of SVF including: osteoarthritis [20, -21], degenerative disc disease [22], sclerosis [23], tendinopathy [24], congestive heart failure [25], chronic obstructive pulmonary disease (COPD) [26], radiation necrosis [27], xerostomia [28], psoriasis [29], and multiple sclerosis [30].…”

Section: Introductionmentioning

confidence: 99%

Intra-Articular Implantation of Stromal Vascular Fraction Plus Platelet Rich Plasma in a Degenerative Meniscal Injury

Comella

Greenberg²,

Ross³

2018

J Med Cases

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Regenerative medicine and specifically stem cell therapy is growing in popularity in a variety of orthopedic conditions including meniscal injuries. Stromal vascular fraction (SVF) which is easily obtained from adipose (fat tissue) is a mixture of adipose derived stem cells/ mesenchymal stem cells, pericytes, fibroblasts, progenitor/endothelial cells, and other cells. A mini-lipoaspiration procedure to obtain a small sample of fat can be completed using a cannula under local anesthesia. The SVF is separated from the adipocytes (fat cells) using enzyme digestion and centrifugation. Platelet rich plasma (PRP) from the peripheral blood is a mixture of growth factors and cytokines. We present a case study and to our knowledge first in man with a before and after arthroscopic evaluation showing the repair of a meniscal tear using SVF plus PRP. Adipose tissue (65 mL) was removed via a mini-lipoaspirate procedure under local anesthesia. Approximately 5 mL of whole fat was washed and prepared for injection. For the remaining 60 mL of fat, the adipocytes were removed after enzyme digestion and centrifugation to isolate the SVF. PRP (approximately 4 mL) was used to resuspend the cells for an intra-articular injection. The patient received five additional PRP injections of 2.5 mL at 3 -4 week intervals. The patient was monitored over a 12-month period for safety (including severe adverse events (SAEs) and adverse events) and quality of life parameters. In addition, an arthroscopic evaluation was completed at baseline and 9 months post procedure. There were no reported SAEs or other safety complications during the procedure or the follow-up time period. The patient demonstrated reduction of pain with clearly visible repair on the arthroscopic evaluation. The patient expressed an overall improvement in quality of life and willingness to repeat PRP treatments. Based on the outcomes of this case study, intra-articular injection of SVF plus PRP could be a feasible treatment plan for a patient with chronic meniscus injury.

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“…Comella et al reported on the safety of SVF in a variety of indications with various delivery methods. Other publications have demonstrated success of SVF for specific conditions including: chronic obstructive pulmonary disease (COPD) [17], congestive heart failure [18], degenerative disc disease [19], osteoarthritis/orthopedics [20][21][22][23][24], radiation necrosis [25], sclerosis [26], tendinopathy [27], xerostomia [28], psoriasis [29] and multiple sclerosis [30]. The following is a case report and to our knowledge first in man a single injection of SVF and PRP into a chronic non-healing stage 3 ulcer in a patient with an incomplete spinal cord injury.…”

Section: Introductionmentioning

confidence: 99%

Injection of Stromal Vascular Fraction Plus Platelet-Rich Plasma in a Non-Healing Decubitus Ulcer

Comella

Ikudayisi

2018

J Med Cases

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Non-healing decubitus ulcers can be challenging to treat and may often progress to other life-threatening complications. Significant tissue damage is present in stage 3/4 wounds and treatment options can be limited or present additional risks. Applications of regenerative medicine and stem cell therapy are rapidly expanding in particular in the field of non-healing wounds. Adipose tissue is a rich source of autologous stem cells which can be easily isolated in an outpatient visit. The population of cells collected from fat after the adipocytes (fat cells) are removed via centrifugation is called stromal vascular fraction (SVF) and contains mesenchymal/adipose stem cells, fibroblasts, pericytes, endothelial/progenitor cells and more. Adipose tissue is collected under local anesthesia via cannula and SVF is separated via centrifugation after enzyme digestion. In addition, peripheral blood can be centrifuged to collect platelet-rich plasma (PRP) which contains a mixture of cytokines/growth factors. Here we present a first in man case study of a single injection of SVF and PRP into a chronic non-healing stage 3 ulcer in a patient with an incomplete spinal cord injury. After removing approximately 60 mL of fat tissue, the SVF was isolated and resuspended in approximately 5 mL of PRP for local administration in the non-healing wound. The wound was monitored and tracked with imaging and the patient was tracked for quality of life parameters as well as safety (adverse events). No complications or other safety events were reported either during the procedure or in the months following the procedure. The patient reported reduction of pain consistent with wound healing and a willingness to repeat therapies if required. The healing stage 3 pressure injury showed clear re-epithelialization. Based on this case study, a feasible treatment plan to promote healing for stage 3 and 4 decubitus ulcers could be a single injection of SVF plus PRP.

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Autologous Adipose-derived Stromal Stem Cell Implantation to Resolve Critical Limb Ischemia: Case Report

Cited by 5 publications

References 13 publications

First-in-man intravenous implantation of stromal vascular fraction in psoriasis: a case study

First-in-man intravenous implantation of stromal vascular fraction in psoriasis: a case study

Intra-Articular Implantation of Stromal Vascular Fraction Plus Platelet Rich Plasma in a Degenerative Meniscal Injury

Injection of Stromal Vascular Fraction Plus Platelet-Rich Plasma in a Non-Healing Decubitus Ulcer

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