Article
Stem cells use in stroke; long term results
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Authors
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Juan Lucino Castillo Rueda
- Mexico City, Mexiko
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Bertin Martinez Silva
- Mexico City, Mexiko
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Juan Carlos Lujan Guerra
- Mexico City, Mexiko
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Antonio Zarate Mendez
- Mexico City, Mexiko
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Manuel Hernandez Salazar
- Mexico City, Mexiko
| Published: | June 18, 2018 |
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Outline
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Background: The need of treatment in patients that doesn’t have alternatives is a reason for the new "restorative neurosurgery", using stem cells in stroke in patients with fixed motor deficit and basal ganglia stroke, demonstrate safety and improvement. Published papers, reports safety and feasibility of neural transplantation using fetal porcine cells in patients with basal ganglia stroke and neurologic deficit.
Methods: It was an open, prospective, randomized longitudinal, experimental and comparative study. It was realized in patients with stroke at the Neurosurgical department at Centro Medico Nacional "20 de Noviembre" ISSSTE. Patients were included with Stroke ischemic diagnosis and motor deficit. On this prospective, experimental study we randomly select patients with stroke and motor deficit to receive either stereotactic transplantation versus no transplantation. 6 patients underwent surgery for autologous stereotactic transplantation after bone marrow stimulation following aphaeresis to obtain peripheral blood stem cells (CD34+, CD133) and 6 in the control group.
Results: 12 patients; 39 to 77 years (mean 61.58). From the beginning of the stroke to cell transplant elapsed mean 14.5 days. Functionality scales were realized. The evaluation was realized at the beginning, at 6 months and every year after until 3 years since.
Transplanted group versus control:
NIHSS stroke scale: baseline 14 ±5; 6 months 11 ±4, (p= 0.169) versus 11 ±7, 6 months 6 ±6 (p=0.055) Barthel Index: baseline 25 ±18; 6 months 5 ±34 (p =0.100) versus 38 ±32; 6 months 68 ±25 (p=0,047). Functional Independence Measure: baseline 41.5; 6 months 58.1 (p=0.110) versus 45.63, 6 months 74.75 (p=0.017)
Objective: It was to evaluate efficacy and security of stem cell transplantation in patients with acute focal brain ischemic Patients were evaluated by validate instrument.
Conclusion: Basic and clinical research stills in a nascent phase, on this study we are showing the safety and a feasible technique. No difference in both groups. Is a small sample of population to conclude effectiveness.
Key words: Ischemic acute stroke, stem cell transplantation
