CELL TRANSPLANTATION THERAPY IN REANIMATING SEVERELY HEAD-INJURED PATIENTS
Severe head injury remains one of main reason for mortality and disability among able-bodied persons. Outcomes of treating head-injured patients are largely defined within acute period of disease. In this period medical interventions are aimed at preventing the injury-triggered, second pathological processes that result in additional damages of brain tissues and are frequently associated with life-threatening consequences. Clinical effects of neuroprotective drugs in acute brain-injured patients are often unclear and doubtful, and there is an apparent necessity to search new approaches to recovery of life-saved, neurological functions.
Cell-based technologies allow to repair affected organs at a cellular level and, thereby, open up fundamentally new opportunities in treatment of many severe diseases, including neurological ones. The central nervous system (CNS) is an "immune-privileged" organ where there are substantial barriers to the development of alloantigen-induced, immune processes. In fact, the grafted neural cells have been convincingly documented to be able to survive in the major histocompatibility complex (MHC)- incompatible CNS for a long period of time. There is also ample evidence from various experimental studies indicating abilities of the transplanted cells to proliferate and elaborate cell growth factors in brain lesions and to intensify markedly, thereby, brain tissue reparation processes .
A total of 38 severely head-injured patients were entered onto the controlled, retrospective clinical investigation. The patients initially were in state of coma (Glasgow coma scale score 3-to-7) owing to their traumatic brain injuries. Cell transplantation treatment was undertaken when consciousness of a patient did not exhibit signs of its recovering as long as at 5-to-8 week post-injury, and when there was a high risk of developing his long-term vegetative status and lethal outcome.
The cells prepared from fetal nervous and hematopoietic tissues were grafted subarachnoidally via a lumbar puncture. Twenty- five patients were cell-grafted once. Other 12, and 1 patients were cell-grafted twice, and thrice, respectively, at an interval of 10-to-14 days.
The control group consisted of 38 patients and was clinically comparable with the trial one.
The cell transplantation treatment was found to promote both wakening consciousness of the patients and their following neurological rehabilitation. As can be seen in Table 1, a death-rate in the trial and control group was 5% (2 cases) and 45% (17 cases), respectively. According to a Glasgow scale, favorable (good + satisfactory) outcomes of a disease were noted in 33 (87%) cell-grafted and only in 15 (39%) control patients.
