Main Factors Predicting Nonresponders to Autologous Cell Therapy for Critical Limb Ischemia in Patients With Diabetic Foot
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
- Keywords
- cell therapy, critical limb ischemia, inherited thrombotic disorders, risk factors,
- MeSH
- Transplantation, Autologous MeSH
- Blood Coagulation Disorders, Inherited complications diagnosis genetics MeSH
- Diabetic Foot complications diagnosis surgery MeSH
- Factor V genetics MeSH
- Heterozygote MeSH
- Risk Assessment MeSH
- Homozygote MeSH
- Ischemia complications diagnosis surgery MeSH
- Critical Illness MeSH
- Middle Aged MeSH
- Humans MeSH
- Methylenetetrahydrofolate Reductase (NADPH2) genetics MeSH
- Mutation MeSH
- Treatment Failure MeSH
- Activated Protein C Resistance complications genetics MeSH
- Risk Factors MeSH
- Aged MeSH
- Cell Transplantation * adverse effects MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- factor V Leiden MeSH Browser
- Factor V MeSH
- Methylenetetrahydrofolate Reductase (NADPH2) MeSH
- MTHFR protein, human MeSH Browser
Autologous cell therapy (ACT) is a new treatment for patients with no-option critical limb ischemia (NO-CLI). We evaluated the factors involved in the nonresponse to ACT in patients with CLI and diabetic foot. Diabetic patients (n = 72) with NO-CLI treated using ACT in our foot clinic over a period of 8 years were divided into responders (n = 57) and nonresponders (n = 15). Nonresponder was defined as an insufficient increase in transcutaneous oxygen pressure by <5 mm Hg, 3 months after ACT. Patient demographics, diabetes duration and treatment, and comorbidities as well as a cellular response to ACT, limb-related factors, and the presence of inherited thrombotic disorders were compared between the 2 groups. The main independent predictors for an impaired response to ACT were heterozygote Leiden mutation (OR 10.5; 95% CI, 1.72-4) and homozygote methylenetetrahydrofolate reductase (MTHFR 677) mutation (OR 3.36; 95% CI, 1.0-14.3) in stepwise logistic regression. Univariate analysis showed that lower mean protein C levels (P = .041) were present in nonresponders compared with responders. In conclusion, the significant predictors of an impaired response to ACT in diabetic patients with NO-CLI were inherited thrombotic disorders.
1st Faculty of Medicine Charles University Prague Czech Republic
Institute for Clinical and Experimental Medicine Prague Czech Republic
References provided by Crossref.org
Cell Therapy of Severe Ischemia in People with Diabetic Foot Ulcers-Do We Have Enough Evidence?
