First word report from Argentina of feasibility of Implant Autologous Stems Cells with Endovascular Technique in Diabetes mellitus patient.

First word report from Argentina of feasibility of Implant Autologous Stems Cells with Endovascular Technique in Diabetes mellitus patient.
Roberto Fernandez Vina MD, Oberdan Andrin MD Jorge Saslavsky MD, Francisco Vraslovick MD,Pinto Andres Tch.
Affiliations: Don Roberto Fernandez Vina Foundation, San Nicolas, Buenos Aires, Argentina - San Nicolas Clinic Buenos Aires Argentina, Medicine Faculty Rosario University, Argentina,
Institutions
After our great experiences of implanting Stems Cells in heart to repair myocardial infarction (more than 70 cases) our group decided to start implanting Stem Cells in the Pancreas to repair the Insulin Beta 2 cells. Many works have demonstrated that stem Cells can cure Diabetes. A 42 years old (male) Diabetes mellitus Type 2 patient was admitted to our Interventional Cardiology Service, to be submitted to an implant "in situ" of Autologous mononuclears Stem Cells (Cd34+, Cd 38-) in the pancreas. The patient accepted the treatment and gave his informed consent. The glycemia at admittance was 3,5g%, and the patient was receiving NPH Insulin and Sulphonylureas. Bone marrow (500cc) was extracted from the iliac crest under local anesthesia. The cellular suspension of Stem Cells was processed to obtain a satisfactory increase in mononuclear cells (13 x 107). The cells tested positive for CD34, an indication of pluripotenciability and differentiation capacity. The enriched suspension in CD34-positive cells (22 x 106) was then re-infused into the Pancreatic Tail Artery 3 hours after bone marrow extraction. A selective catheterization of Spleen Artery was made using Judking Technique from a femoral puncture with an angiographic Side Winder Catheter 6 Fr.The angiography showed the Posterior or Tail and Medial or Gender Pancreatic Arteries and the Spleen Artery’s Terminals branches inside the Spleen.(Fig 1-2). A 3m. Interchange wire was placed inside the Spleen artery and the Diagnosis Catheter was retired, then over this wire a Judkin RC 6F Guide catheter was sliced and placed inside the final portion of Spleen Artery before the origin of Pancreatic Tail Artery. Two 0.0014 wires were placed inside the Spleen’s terminals branches. Two Ballon Coronary Angioplasty catheters (4mmx20 mm & 3,5mmx20mm) were sliced over each wire and placed in the beginning of the Spleen Artery bifurcation after the beginnig of Pancreatic Tail artery (Fig 3-4). Both balloons were inflated with low pressure to occlude the distal flow of Spleen artery and derivate the blood flow inside the Pancreatic artery to the Pancreas tail. The enriched suspension in CD34-positive cells (22 x 106) was then re-infused into the final portion of the spleen artery through the Catheter that was maintained occluded with the balloons during the infusion to derivate the cells inside the pancreas. After having injected Stems cells solution it was injected 50 ml of Saline Solution to improve the flow inside the Pancreas. Dr. Roberto Fernandez Vina Foundation - San Nicolás Clinic, Buenos Aires, Argentina - Maimonides University, Buenos Aires, Argentina
The balloons were deflated and retired and it was made a new angiographic control that did not show occlusion or embolism of spleen’s terminal arteries and good flow inside the Pancreas Tail arteries.
The sheath was retired after 2 hours and the patient was discharged from the hospital after 24 hours without complications.
Conclusion: During the first post implant week, the glycemia decreased to 2,5g% and the glycosuria decreased as well, and after the second week the glycemia decreased to 1,50g% with a minimal Sulphonylureas dose. Amylase increase was not reported Comment: The endovascular way technique to implant Stems cells in a selective way in the Pancreas Tail to avoid complications of massive stems cells implant is a safe way and an easy procedure not only to implant Adult Stems Cells but also to infuse drugs (grown factors) inside the Pancreas to improve of Beta 2 Cells regeneration in Diabetic Patients.