Umbilical cord blood stem cell transplantation for the treatment of diabetic foot in 11 cases

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Totally 11 subjects with diabetic foot have been treated by umbilical cord blood mesenchymal stem cell (UCB-MSC) transplantation from November 2006 to October 2008 at the Chengyang People's Hospital of Qingdao City. The course of disease was 6-18 years. Following over 6-months drug treatment and/or scaffold implantation, vascular bypass outcomes were bad. Of these patients, there were foot and/or lower limb cooling, pain, intermittent claudication and rest pain in 7 cases, abnormal color in foot skin in 7 cases, foot ulcer in 6 cases, gangrene in 4 cases, and concurrent infection in 2 cases. UCB-MSCs were obtained from healthy pregnant women, and supplied by Beike, Shenzhen, China. Following epidural or lumbar anesthesia, UCB-MSC suspension [cell number (1-6)×1011/L, 0.3-0.5 mL per point] was injected into affected lower extremity through multipoint muscles, with a distance among each point was about 3 cm × 3 cm. Demixing injection could be performed in regions with plenty of muscles. At 1-4 weeks following transplantation, foot pain in 9 cases got amelioration or easement and cold sensation in 10 cases improved markedly. At 4-16 weeks after transplantation, foot ulcers were better and ulceration area reduced in 4 cases, gangrene area in 2 patients reduced and avoided amputation. 1 limb was amputated but with lowered level of amputation. After 12-24 weeks, 6 patients with intermittent claudication improved obviously, ankle-brachial index (ABI) increased in 3 cases, angiography showed an increase in visible collateral vessels in 3 patients. Transplantation of UCB-MSCs might be a simple, safe and effective method for patients with lower limb ischemia. It can effectively increase blood flow of lower limbs, promote ulcer healing and decrease amputation rate and amputation level.

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