医学
外科
基质血管部分
耐火材料(行星科学)
不利影响
富血小板血浆
临床终点
放射性武器
脂肪组织
瘘管
内科学
血小板
随机对照试验
天体生物学
物理
作者
Jeanine Arkenbosch,Oddeke van Ruler,Roy S. Dwarkasing,Gwenny M. Fuhler,W. R. Schouten,Marjolein Blussé van Oud-Alblas,Eelco J. R. de Graaf,Annemarie C. de Vries,Christien J. van der Woude
摘要
Summary Background An unmet need remains for improved management in perianal fistulising Crohn's disease (pCD). Recently, local administration of adipose‐derived cells has shown promising results. Aims To assess the safety and feasibility of injection of stromal vascular fraction (SVF) with platelet‐rich plasma (PRP) in patients with pCD. Methods Patients ≥ 18 years with pCD were included and underwent fistula curettage, SVF with PRP injection, and closure of the internal opening. The primary endpoint was safety at 12 months. The secondary outcomes were complete radiological healing at 3 months (absence of fluid‐containing tracts on MRI) and partial and complete clinical response at 3 and 12 months (closure of ≥1, respectively, all treated external opening(s)). Results Twenty‐five patients were included (35 [IQR 25–40] years; 14 [56%] female); median CD duration 4 [IQR 2–8] years. Twenty‐four (95%) patients had previously undergone fistula surgery. No adverse events were encountered at lipoharvesting sites. Two (8%) patients were readmitted to hospital and six (24%) underwent unplanned re‐interventions. Post‐operative MRI ( n = 24) showed complete radiological healing in nine (37.5%) patients. Partial clinical response was present in 48% (12/25) at 3 months and in 68% (17/25) at 12 months, and complete clinical closure in five (20%) patients at 3 months and in 10 (40%) patients at 12 months. Conclusion Injection with autologous SVF with PRP is feasible and safe in patients with treatment‐refractory pCD. Early complete radiological healing was observed in more than one‐third of patients, and clinical response in two‐thirds of patients at 12 months.
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