Thromboembolism Induced by Umbilical Cord Mesenchymal Stem Cell Infusion: A Report of Two Cases and Literature Review

• Published in: Transplantation proceedings Vol. 49; no. 7; pp. 1656 - 1658
• Main Authors: Wu, Z., Zhang, S., Zhou, L., Cai, J., Tan, J., Gao, X., Zeng, Z., Li, D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017
• Subjects: Adult; Humans; Kidney Transplantation - adverse effects; Kidney Transplantation - methods; Male; Mesenchymal Stem Cell Transplantation - adverse effects; Mesenchymal Stem Cell Transplantation - methods; Mesenchymal Stromal Cells; Middle Aged; Postoperative Complications; Renal Insufficiency, Chronic - surgery; Thromboembolism - etiology; Umbilical Cord - cytology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2017.03.078

To investigate the thromboembolism induced by blood-mediated inflammatory reactions against infused cells during the clinical application of stem cells. Two patients with renal transplantation and chronic kidney disease, respectively, experienced thromboembolism after umbilical cord mesenchymal stem cell (UCMSC) infusion. The clinical manifestations and the laboratory test results were collected and analyzed. The patients received stem cell infusion through the peripheral veins and presented with a swollen and painful forearm postinfusion. Doppler ultrasound showed venous clots at the proximal end of the puncture site. Urokinase and warfarin were used for thrombolytic therapy. The swelling and pain were relieved and cured. Safety concerns are still a primary hurdle for stem cell therapy, and thromboembolism as a critical complication should be prevented appropriately. •Thromboembolism induced by stem cell infusion causes venous obstruction and swollen extremities.•Thrombolytic therapy with urokinase and warfarin can successfully cure stem cell thrombosis.•Literature regarding the mechanisms of stem cell-induced thrombosis was comprehensively reviewed to study the roles of instant blood-mediated inflammatory reaction and cell culture-relevant tissue factor overexpression. Better anticoagulant regimens are required for safer clinical applications of stem cells.