关键词: 肢体缺血, 干细胞, 转化医学

Abstract:

Stem cell transplantation in treatment of limb ischemia             DONG Zhi-hui, FU Wei-guo. Department  of  Vascular Surgery, Zhongshan Hospital, Fudan Universty Institute of Vascular Surgery, Fudan University, Shanghai 200032, China
Corresponding author：FU Wei-guo,E-mail: fu.weiguo@zs-hospital.sh.cn
Abstract    As one of the branches of regenerative medicine, stem cell transplantation has already been used in clinical practice for management of surgically difficult limb ischemia in a translational fashion after a series of basic researches. Up to 30% of patients with critical limb ischemia are not eligible for current reconstructive procedures, either surgical bypass or endovascular revascularization, who will resultantly lose their limbs or even lives. For them, stem cell transplantation provides a novel treatment alternative. According to the type of the transplanted cells, it could be divided into 3 categories: bone narrow mononuclear cells (BM-MNC) transplantation, peripheral blood mononuclear cells (PB-MNC) transplantation, and purified peripheral blood CD34+ Cells (PPB-CD34+C) transplantation. BM-MNC was the initially used cell type because of its high proportion of CD34+ cells. However, it usually requires a high-volume aspiration of bone marrow and the general anesthesia. PB-MNC offers a more convenient and less invasive way of apheresis, particularly after the employment of G-CSF which significantly elevated the number of peripheral CD34+ cells. Successful application of PPB-CD34+C was recently reported, eliminating the coexisting cells which were considered bringing a potential risk of inflammatory reaction. So far, transplantation of either type of cells could yield satisfactory treatment outcomes for limb salvage. Their respective mid-to-long-term results and the difference in efficacy between them are pending follow-up and a randomized control study.

Key words: limb ischemia, stem cell, transplantation;translational medicine