Application of mesenchymal stem cells from adipose tissue for the treatment of perianal fistula
- Modern and innovative form of treatment
- An addition to the first act of treatment or a stand-alone method after several previous failed perianal fistula repairs
- No long recovery periods
- The patient leaves the hospital the same day
The application procedure of mesenchymal stem cells from adipose tissue uses the most modern technology that processes autologous adipose tissue cells for the purpose of treating injuries or damage to specific tissue. The microfragmented fat tissue obtained by this procedure is injected/injected into the parts of the body where there is an indication, in order to stimulate regenerative processes and thus healing. The application of stem cells enhances regenerative processes as an adjunct to surgery, and is also used as an independent therapeutic method, depending on the individual circumstances of the patient. We find the particular importance of applying this method of treatment in refracted, persistent fistulas that have not been successfully treated with conservative measures or earlier surgical repairs. Also, the application of stem cells offers a better chance of healing in combination with primary surgical treatment of perianal fistula.
The importance of adipose tissue is best illustrated by the fact that per gram of adipose tissue we find up to 500 times more pluripotent stem cells compared to 1 gram of bone marrow. Stem cells and pericytes (Rouget's cells) obtained from adipose tissue, according to the latest knowledge, have great potential in reparation of various types of tissue, from bone and cartilage to connective tissue, muscle and skin. In addition to a larger amount of pluripotent stem cells, obtaining them from the patient's fat tissue offers a low-risk method of aspiration, and an immediately applicable preparation of mesenchymal stem cells - applicable in the same act as liposuction.
According to the available literature, mesenchymal stem cells (MSCs) have several important functions, among which are the release of the so-called trophic factors that, among other things, prevent cell death (apoptosis) as well as the formation of scar tissue, stimulate the formation of new blood vessels and have a mitogenic effect for tissue-specific progenitors, which can ultimately lead to the repair of damaged tissue or even a regenerative effect. Pericytes (PCs) have similar effects, which can modulate the immune response and have a multipotent ability to differentiate (similar to MSCs), as well as the ability to modulate the inflammatory response (preventing an overly aggressive immune response), but also play an important role in vasculogenesis (the development of new blood vessels during embryogenesis) and angiogenesis (formation of new blood vessels from existing ones). Recently published works suggest that MSCs mainly arise from perivascular cells, pericytes (PC) (2). Human adipose (fat) stem cells (hASCs), which are taken from the patient during the application of mesenchymal stem cells from adipose tissue, in accordance with the principles of the "point of care" model, and after separating the so-called "stromal vascular fractions" re-injected into the patient have potential in the treatment of various clinical conditions.
Personalised medicine, which includes cell therapy and regenerative medicine, has been gaining momentum in recent years. The European Commission founded the International Consortium of Personalized Medicine (ICPerMed), and the Republic of Croatia founded the Croatian Competitiveness Cluster of Personalized Medicine, of which the St. Catherine Specialty Hospital is also a member.
Treatment with the application of mesenchymal stem cells from adipose tissue in St. Catherine Specialty Hospital has been applied since November 2015. The procedure is also applied by other world centers such as the best American orthopedic hospital, Hospital for Special Surgery, Cleveland Clinic, Institute of Regenerative and Molecular Orthopedics, USA, Image Medical Spa, Italy, Lipogems, a company that has initiated scientific cooperation with a number of centers, including Case Western Reserve University, USA (Prof. Dr. A. Caplan), Orthopedics and Trauma Division, Azienda-Ospedaliera Universita di Modena, Universita di Modena a Reggio Emilia, Italy (Prof. Dr. F. Catalani), Center for Regenerative Medicine, Edinburgh, University of California, USA (Prof. Dr. B. Peault), Division of Cellular Transplantation, Department of Surgery and Diabetes Research Institute, University of Miami, USA (Dr. C. Ricordi), Laboratory of Molecular Biology and Stem Cell Engineering, Universita di Bologna (Prof. Dr. C. Ventura) and a number of others.
Guided by the most modern diagnostic and treatment methods in the St. Catherine Specialty Hospital a clinical study was conducted that included a therapeutic procedure applied to patients with osteoarthritis of the knee. The results of our study suggest that the application of autologous microfragmented adipose tissue with stromal vascular fraction in patients with OA leads to an increase in glycosaminoglycans in hyaline cartilage, which is consequently accompanied by a reduction in pain and an improvement in the mobility of the observed patients. Also, the analysis of the N-glycan profile of IgG from blood and synovial fluid proved that local and systemic inflammatory responses do not develop with the use of this therapy.
Application of mesenchymal stem cells from adipose tissue
The application procedure of mesenchymal stem cells from adipose tissue uses the most modern technology that processes autologous adipose tissue cells for the purpose of treating injuries or damage to specific tissue. The microfragmented adipose tissue obtained by this procedure is injected into parts of the body where there is an indication in order to stimulate regenerative processes and thus healing.
The therapeutic procedure "application of mesenchymal stem cells from adipose tissue" optimizes the use of fat cells in order to stimulate the natural process of regeneration and healing. This procedure was awarded in 2016 as the best new technology in sports medicine by top medical experts from leading institutions in the USA, and recently, its use in abdominal surgery has intensified, especially in the treatment of perianal fistulas. Mesenchymal stem cell treatment is also being investigated in fecal incontinence, and is thought to offer the potential for improved anastomotic healing in other areas of abdominal surgery.
Description of the procedure "Application of mesenchymal stem cells from adipose tissue“
The patient who is treated with this procedure at the hospital of St. First, Katarina's detailed anamnestic data is taken, the most important of which is the evaluation of the therapies applied so far, the currently prescribed therapy for the patient and its correlation with the application of mesenchymal stem cells, any underlying pathology and the assessment of the need for additional treatment of the patient in order to rule out an unrecognized cause of the fistula. Then follows a detailed clinical examination, and in the case of locally active septic complications, it is necessary to rehabilitate them first, with drainage of possible local inflammatory collections. Then the procedure can be started.
If you are a candidate for the mentioned procedure, orthopedic surgeon will aspirate a small portion of your fat tissue, and the collected fat tissue will be processed in a special system that contains a sterile salt solution. During the micro-fragmentation process, the fat is washed and processed into smaller fragments, where all the essential cellular components that stimulate regenerative processes remain, while cellular impurities such as blood, cell debris and oils are removed. This is followed by local preparation and debridement (removal of inflamed and pathologically changed tissue inside the fistula channel and at its openings). Your doctor will then inject the obtained mixture of microfragmented fatty tissue around the fistula canal and its openings. The procedure itself takes a relatively short time, approximately one hour, and is minimally invasive. There are studies that speak in favor of the analgesic effect of mesenchymal stem cells (potentially significantly less postoperative pain), and the anti-inflammatory and regenerative effect has been confirmed. The recovery time after the application procedure of mesenchymal stem cells from adipose tissue is extremely fast.
Are you a candidate?
You are a candidat if:
- your doctor determines the application of stem cells as an option for your treatment
- you suffer from recurring complaints and secretions from a perianal fistula, so far unsuccessfully treated with conservative and/or surgical approaches
- you want to improve the chances of healing and less postoperative pain already at the first surgical repair of perianal fistula
Want to find out if you are a candidate for the procedure? Arrange an appointment using our contact form..