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P340. Therapy of intestinal fistula with autologous adipose tissue derived stem cells doesn't lead to fistula closure in animal model – first results

O. Ryska1, Z. Serclova1, O. Mestak2, E. Matouskova3, P. Vesely2, 1Central Military Hospital, Department of Surgery, Prague 6, Czech Republic, 2Bulovka Hospital, Department of Plastic Surgery, Prague 8, Czech Republic, 33rd Medical Faculty Charles University, Department of Burns Medicine, Prague 10, Czech Republic

Background

Conservative and surgical treatment of perianal fistulas in patients with Crohn's disease is effective in about 40–60%. Local administration of Adipose Tissue Derived Stem Cells (ADSCs) represents new potential treatment modality in IBD perianal fistulas, but has never been proved in animal model.

Methods

Coecostomy with 2–3 cm long subcutaneous canal was used as a model of intestinal fistula in 9 Whistar rats. The adipose tissue from inguinal region has been harvested and ADSCs has been isolated using collagenase technique and cultured in H-MEM medium. Acellular xenodermis (Xe-Derma) as a layer was settled by ADSCs in vitro. The Xe-Derma plug was applied into the fistula tract followed by injection of ADSCs suspension in the peri-fistular tissue. The fistula was evaluated 2nd, 5th, 7th and 30th postoperative day.

Results

All fistulas remain open 4 weeks after coecostomy creation which was confirmed by fistulography. Cell suspension with concentration 1×106/ml was obtained from groin adipose tissue and cultured on Xe-Derma layer. Application of ADSCs was technically successful in all cases without morbidity and mortality. However, all fistulas remain opened during the 30 days follow-up.

Conclusion

The technique of intestinal fistula model, isolation and application of ADSCs using acellular xenodermis was introduced. The fistula recurrence was observed in all animals. Further intervention with repeated sequenced cell application should be performed. Different cell carrier will be proved.

Supported by a grant from IGA: NT13708