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Successful wound healing by autologous peripheral blood mononuclear cell therapy in a diabetic patient on hemodialysis with no-option critical limb ischemia: a case report

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Abstract

Peripheral artery disease is a common condition in patients on chronic dialysis treatment, end-stage kidney failure itself being a risk factor. The most severe stage of peripheral artery disease, critical limb ischemia, causes marked chronic pain and is associated with risk of limb loss. Despite improvements in revascularization procedures, the results of limb salvage procedures among dialysis patients remains poor, and lower extremity amputation is associated with high mortality and grim socio-economic implications. We report on a limb salvage approach that was successfully employed in a 74-year-old woman on hemodialysis suffering from no-option critical limb ischemia complicated by diabetic foot infection, i.e. otherwise a candidate for major amputation. The approach consists in implanting in the wound bed of the affected limb a concentrate of autologous peripheral blood mononuclear cells collected from the peripheral blood of the patient using a selective filtration separation system. The procedure, performed by a vascular surgeon in an outpatient setting and sterile conditions, was repeated three times at intervals of 15 days, and was well tolerated; no adverse safety signals were observed. Complete wound healing was obtained, with successful limb rescue.

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Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Nephrology and Dialysis Unit, Department of Medicine, SS. Annunziata Hospital, G. d’Annunzio University, Via dei Vestini, 66100, Chieti, Italy

    Martina Capone, Olsi Ndrecka, Lorenzo Di Liberato & Mario Bonomini

  2. Vulnology Service, SS. Annunziata Hospital, Chieti, Italy

    Raffaele Trulli

Authors
  1. Martina Capone
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  2. Raffaele Trulli
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  3. Olsi Ndrecka
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  4. Lorenzo Di Liberato
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  5. Mario Bonomini
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All authors have been personally and actively involved in substantial work leading to the paper. All authors read and approved the final manuscript.

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Correspondence to Mario Bonomini.

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The authors have no relevant financial or non-financial interests to disclose.

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Ethical approval was not sought in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Capone, M., Trulli, R., Ndrecka, O. et al. Successful wound healing by autologous peripheral blood mononuclear cell therapy in a diabetic patient on hemodialysis with no-option critical limb ischemia: a case report. J Nephrol (2024). https://doi.org/10.1007/s40620-023-01876-6

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  • DOI: https://doi.org/10.1007/s40620-023-01876-6

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