Chen Ling-zhen, Chen Jia-yu, Wu Jin-ming, Yu Wei, Zhan Yu

Abstract
BACKGROUND: Previous studies have shown that bone marrow mesenchymal stem cells (BMSCs) can differentiate into vascular endothelial cells, and then further differentiate into new blood capillary, resulting in forming new collateral branch and in improving blood supply in local site, which can provide new ideas for treatment of ischemic lower extremity disorders.
OBJECTIVE: To observe clinical effects of autologous BMSCs transplantation on the treatment of severe diabetic foot.
METHODS: One patient with type 2 diabetes and severe diabetic foot ulcers was included in this research. BMSCs were isolated and expanded from 50 mL bone marrow aspirates through lower-extremity artery CT vascular reconstruction, which suggested lower-extremity angiosclerosis, stenosis and occlusion. Mononuclear cells were harvested by density gradient centrifugation, and BMSCs were isolated and purified using adherent culture method, and then infused into patients via intravenous infusion following microbiological detection. At 3 and 6 months, 7 and 30 days following transplantation, clinical symptoms such as pain, cold sensation, intermittent claudication, ankle-brachial index (ABI), ulcer area and gangrene were observed. Improvement and blood flow in the lower extremity and artery lateral branch reconstruction were measured by color Doppler flow imaging and CT scan.
RESULTS AND CONCLUSION: At 3 months following transplantation, pain and cold sensation significantly relieved and numbness was improved. At 6 months after transplantation, pain relief was achieved, ABI significantly increased, foot ulcers healed completely, lower extremity was maintained, and foot function in walking was well preserved. New vessels formation was visible and blood flow was significantly improved by color Doppler flow imaging and CT scan. No heart/live/lung/kidney function injury was observed during the transplantation. The patient was followed up for 14 months, no transplantation-related complications were observed. Autologous BMSCs transplantation provides a new way for the therapy of diabetic foot.

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