Closure of a recurrent bronchopleural fistula using a matrix seeded with patient-derived mesenchymal stem cells

Johnathon M. Aho, Allan B. Dietz, Darcie J. Radel, Greg W. Butler, Mathew Thomas, Timothy J. Nelson, Brian T. Carlsen, Stephen D. Cassivi, Zachary T. Resch, William A. Faubion, Dennis A. Wigle

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Management of recurrent bronchopleural fistula (BPF) after pneumonectomy remains a challenge. Although a variety of devices and techniques have been described, definitive management usually involves closure of the fistula tract through surgical intervention. Standard surgical approaches for BPF incur significant morbidity and mortality and are not reliably or uniformly successful. We describe the first-in-human application of an autologousmesenchymal stemcell (MSC)-seededmatrix graft to repair amultiply recurrent postpneumonectomy BPF. Adipose-derivedMSCs were isolated from patient abdominal adipose tissue, expanded, and seeded onto bio-absorbable mesh, which was surgically implanted at the site of BPF. Clinical follow-up and postprocedural radiological and bronchoscopic imaging were performed to ensure BPF closure, and in vitro stemness characterization of patient-specific MSCs was performed. The patient remained clinically asymptomatic without evidence of recurrence on bronchoscopy at 3months, computed tomographic imaging at 16 months, and clinical follow-up of 1.5 years. There is no evidence ofmalignant degeneration ofMSC populations in situ, and the patient-derived MSCs were capable of differentiating into adipocytes, chondrocytes, and osteocytes using established protocols. Isolation and expansion of autologous MSCs derived from patients in a malnourished, deconditioned state is possible. Successful closure and safety data for this approach suggest the potential for an expanded study of the role of autologous MSCs in regenerative surgical applications for BPF.

Original languageEnglish (US)
Pages (from-to)1375-1379
Number of pages5
JournalStem Cells Translational Medicine
Volume5
Issue number10
DOIs
StatePublished - Oct 1 2016

Keywords

  • Bronchopleural fistula
  • Cell transplantation
  • Cellular therapy
  • Clinical translation
  • Mesenchymal stem cells
  • Stem cell transplantation

ASJC Scopus subject areas

  • Developmental Biology
  • Cell Biology

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