Stem Cell Procedure
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How and Where Is My Therapy Done?
You have taken the right decision to undergo stem cell therapy for a healthy and better life. It is our sincere attempt to support and make this journey of yours, a comfortable one.
Prior to treatment, our clinical staff will guide you through a medical counselling session where we will provide you with detailed information regarding: stem cell-therapy procedure, treatment outcome expectations, and possible side-effects. Post counselling session, you may undergo some clinical tests for the assessment of your medical reports. Following that, we will further intimate you regarding the treatment modalities and your therapy schedule.
The treatment procedure will be performed under careful medical surveillance of healthcare specialists and a highly-dedicated team of physicians, patient advisors, and nurses will always be available to assist you. Besides therapeutic expertise, Advancells also provides facilities of hotel booking, local transportation, and visa assistance, for our outstation patients. We make sure that all your queries, doubts, and worries get resolved, to make you feel more confident and at peace.
Eligibility Criteria for Treatment
- Age of 18 years or older (Parental Approval needed for under 18 years)
- Agreement for signed informed consent form
- No severe chronic condition/ disease stage
- Haemoglobin level is less than or equal to 10
- Patients with congenital blood disorders
- Refusal to provide signed informed consent
- Medical surgery within six weeks prior to treatment
- Pregnant or breast-feeding women
- Severe Cachexia and malnourishment
- Patients with compromised immunity
- Positive serology test for infectious diseases
Stem Cells Procedure: The 4-step Advancells Protocol
Stem Cell Processing
Stem cell Implantation
Advancells Therapy , based on the principle of “Good Manufacturing Practices”, is performed with the most advanced technology and medical standards. Our stem cell therapy preferably utilizes the patient’s own adult stem cells to avoid any graft-host rejection risk or side effects.
Depending on patient assessment reports, our specialized medical expert decides the source of stem cells, i.e., Bone marrow or Adipose tissue, for the therapy.
Bone Marrow Derived Adult Stem Cells Extraction
One of our experienced doctors will extract the bone marrow from the iliac crest (Hip Joint). Normally, the procedure will take around 30-45 minutes. After administering local anesthesia, a bone marrow extraction needle will be used to extract about 100-120 ml of bone marrow. An option of general anesthesia will also be available for patients who need it. Once the extraction is done, the sample will be immediately transferred to our clean room facility for processing.
More detailed information on the bone marrow collection procedure is available in the Bone Marrow Informed Consent document (PDF file).
Isolation of stem cells from Bone Marrow
In a clean room, stem cells will be separated from other mature blood cells and plasma. The processing of samples will be done as per the cGMP standards under sterile conditions. Utmost care will be taken to make sure that stem cells do not get contaminated by any kind of infections. Post processing all samples will be tested for quality and quantity of stem cells.
Adipose Tissue Derived Adult Stem Cells Extraction
One of our experienced doctors will extract adipose tissue from specific areas of the body. Once the location is confirmed, patients will be asked to lie in a supine position and given local anesthesia. A 60 CC cannula will be inserted under subcutaneous layer and approximately 100 CC adipose tissue will be collected. Once the aspiration is completed, the sample will be immediately transferred to the clean room for further processing.
More detailed information on the adipose Tissue collection procedure is available in the Adipose Tissue Informed Consent document (PDF file)
Isolation of Stem Cells From Fat
In our clean room facility, progenitor/stem cells will be separated from other mature cells present in fat, such as macrophages, adipocytes etc. The processing of sample is done as per approved cGMP standards under sterile conditions. Utmost care is taken to make sure that stem cells do not get contaminated by infectious agents. Post processing, all samples will be tested for quantity as well as quality.
Advancells provides each client with a third-party authentication certificate (from an internationally accredited lab) for viability and quality assessment of stem cells and related regenerative medicine-based products.
Stem Cell Implantation
For optimum therapeutic performance, stem cells can be administered in the patients’ body via different routes:
1. Intravenous Administration
Intravenous (IV) administration is the infusion of stem cells via the patient’s veins. Mannitol is used as a supplementary agent with IV drip to expand the blood volume around central nervous system. This ensures optimum efficacy with maximum no. of cells reaching the target area. Intravenous administration image.
Intravenous (IV) administration is the infusion of stem cells via the patient’s veins. Mannitol is used as a supplementary agent with IV drip to expand the blood volume around central nervous system. This ensures optimum efficacy with maximum no. of cells reaching the target area:
- Right dose is given to the right patient
- Patient is not allergic to IV dose
- The infusion is done aseptically at the right time
More detailed information on the IV administration procedure is available in the IV-Mannitol Informed Consent Document (PDF File)
2. Intrathecal Administration (Lumbar Puncture)
Intrathecal administration involves stem cell infusion via spinal canal injections, popularly known as lumbar puncture. Using this route of administration, optimum delivery of stem cells to the cerebrospinal fluid can be achieved without being affected by the blood-brain barrier. This route is particularly efficient in case of neurological disorders.
For the infusion process, a small volume of spinal fluid is extracted from the lumbar region and an equivalent volume of stem cells is implanted in the same vertebra region. This nullifies the pressure difference in the spinal fluid column.
Patients may experience mild side effects of dizziness and headache to cope up with the spinal fluid pressure difference. These symptoms may last only for 1-2 days and can be slightly prominent while getting up from a horizontal sleeping position. Rest assured, these symptoms do not pose any risk to the patients’ health.
More detailed information is available in the LP Informed Consent Document (PDF File)
3. Intra-Muscular Administration
Intra muscular injection is infusion of stem cells directly into the muscles. It is used in particular when small amount of cells are to be administered. The procedure is through injection ensuring release of pool of stem cells directly to the affected area. Target area with ailing tissues can include knee, shoulders, hips etc. Hence the ideal site for administering the injection are Thighs, Top of upper arm, Knee, Hips.
Once the targeted muscular injection is administered, the pool of stem cells reach the diseased area and effectively begin the process of rejuvenation and repair. Clinical results have further indicated that a combination of intramuscular injections with more than one infusion protocol is much more beneficial in promoting the regeneration and functional recovery of musculoskeletal environment.
4. Intra-Arterial Administration via catheter
Intra-arterial infusion of stem cells is performed through a thin catheter inserted into the patient’s artery. Prior to infusion, the catheter is very carefully directed towards the targeted area to ensure maximum cell delivery for optimum efficiency. This route of administration is generally preferred for vascular organs such as kidney, heart, and pancreas.
5. Intravitreal Infusion
The intravitreal drug delivery has become the most reformed technology in treating some of the ophthalmic conditions such as macular oedema, retinal vein occlusions, etc. These are the conditions wherein single dose administered through intravitreal region is more effective than repeated injections through retrobulbar mode.
The inside of the human eye is filled with a jelly like fluid known as “Vitreous humor ”. An intravitreal injection is a direct shot of stem cells into the vitreous structure near the retina, at the back of the eye. The entire procedure takes no more than 15-20 minutes.
- The procedure requires dilation of the pupil by placing specific eye drops in the eyes.
- Once pupils are dilated, the patient will be allowed to lie in a comfortable position and anaesthetic drops will be provided.
- After cleaning both the eyes and the eyelids using the iodine antiseptic solution, the eyes are kept open during the entire procedure with the help of a small device.
- A shot of stem cells will be injected directly into the vitreous region with the help of small needle; a patient may feel slight pressure on the eye without any pain.
- The eyes will be checked properly and some antibiotic ointment might be placed in the eyes, if required.
6. Retrobular Infusion of Cells
The retrobulbar injection procedure is routinely exercised by many ophthalmologists for the infusion of stem cells to treat eye diseases such as, Macular Degeneration, Glaucoma, and other disorders.
In this procedure, a specific needle is carefully inserted inferior to the maximum eye diameter perpendicular to your face, under local anesthesia conditions. Once past the axis, the needle is angled medially and superiorly before finally positioning within the muscle cone. Following that, a pool of viable stem cells are injected near the macula region, under the eye.
This method of stem cell administration is preferred for eye disorders as a higher number of cells can be directly targeted to optimize the output. In some cases, a combination of two protocols may be suggested by the experts in the best interest of patient well-being.
7. Liberation Angioplasty for Multiple Sclerosis CCSVI
CCSVI Treatment Step 1 – Liberation Angioplasty
Liberation Angioplasty is a very critical process. X-ray scanning is used to guide the catheter with the balloon tip to the affected area or veins. Once it reaches the targeted area, the tip expands resulting in the widening of the stenotic area. The entire process takes around 90 minutes. Then the patients are kept in recovery room for around 4 hours to ensure that there is no bleeding from the catheter insertion tract.
CCSVI Treatment Step 2 – Insertion of Stem Cells
After the first step of liberation angioplasty the blood flows with ease through the stenotic veins. This is essential in order to determine the effective potential of the stem cells introduced to transform into specialized cells necessary for regeneration or repair of damaged tissue of the brain or the spinal cord. This procedure can also reduce the inflammation throughout the body. Many of the patients have reported that the recovery is extremely fast after this treatment.
8. Intra-dermal Administration
Around the skin wounds :- Intra-dermal administration for wounds is specifically used in case of open sores such as diabetic foot or pressure ulcers. The procedure involves direct infusion of stem cells into or around the wound area, e.g., dermal layer of the skin. The skin dermal layer is the most preferred layer as it is highly vascularized and contains a high concentration of immune cells. Through this route, infused stem cells can promptly elicit and strengthen the body’s natural healing signals for faster recovery.
Around the hair follicles :- In this procedure, Platelet Rich Plasma (PRP) along with a pool of stem cells is infused around the hair follicles using micro-needles, after local anesthesia of the scalp area. This intra-dermal, local application of PRP with stem cells can accelerate the healing process around the follicles immediately to stimulate the native stem cells. These native cells, in turn, provide strength, support, vitality and resilience to the follicles and help in generating natural new hair strands.
Platelet Rich Plasma for facial skin :- In this procedure, Platelet Rich Plasma (PRP) along with a pool of stem cells is infused using micro-needles, after local numbing of the face area. The face is locally numbed using numbing cream and the infusion is accordingly administered at different facial regions such as around the eyes, lips, chin, etc. This intra-dermal, local application of PRP with stem cells can accelerate the healing process immediately to stimulate the native stem cells. These native cells enhance the production of collagen and the removal of photo-damaged skin cells, pigmentations, and wrinkles, giving way to a radiant natural skin.
In general, most of the intradermal injections are delivered inside the skin through micro-needles using mantoux technique (the needle is inserted at an angle of 5-15 degree).
9. Tissue Reconstruction through Biodegradable Scaffolds
Through the advanced developments in the field of Tissue Engineering, regeneration of damaged tissue is possible by allowing rapid cellular integration into an optimized biocompatible scaffold.
These porous three-dimensional scaffolds essentially act as tissue regeneration templates where stem cells are implanted with PRP. Thus, the regeneration process is systematically allowed through a triad combination of stem cells, signaling pathways and biodegradable material.
Different Types of Scaffolds that can be used in tissue reconstruction
Autograft or Autologous Bone Graft is constructed using the patient’s own bone tissue. An autograft tissue is typically obtained from the chin, jaw, lower leg bone, hip, and skull. The main advantage of an autograft is the presence of living cellular elements that enhance bone growth. However, one of the major drawbacks of autografts is the requirement of a second procedure for bone harvest.
Allograft or Allogenic Bone Graft is basically a dead bone harvested from a cadaver, which is further processed to form a framework or scaffold to support bone regeneration from the surrounding tissue. The main advantage of an allograft is its ability to support stem cell culture in the form of a good biocompatible scaffold
Xenograft of Xenogenic Bone Graft is derived from the living bone of other species, such as cow or pig. This type of bone graft is processed at a very high temperature to avoid any potential immune rejection or contamination. Similar to allografts, xenografts can also be used as bio-scaffolds.
10. Surgical Administration for patients having stroke or SCI
Brain surgery for stem cell infusion requires a lot of modern technical equipment and tools in order to operate and infiltrate the skull (Craniotomy). A highly valued advanced brain navigation system is used in order to reduce any kind of brain tissue damage during surgery. Strict protocols of anesthesia and surgery are followed for this procedure of stem cell administration. After the surgery, patients are generally kept under observation in the care unit for a night and thereafter shifted to the normal ward, prior to being discharged from the hospital.
Surgery of the Spine
Spinal surgeries for stem cell infusion are also very critical and require ultramodern technical equipment to operate and infiltrate the spinal cord/vertebrae (Laminectomy). In this procedure, after the spinal column is incised, a further incision is done on the embedded dura-mater. Following that, a pool of viable stem cells is infused using a very fine needle and the incisions are sealed accordingly. Strict protocols of anesthesia and surgery are followed for this procedure of stem cell administration. After the surgery, patients are generally kept under observation in the care unit for a night and thereafter shifted to the normal ward, prior to being discharged from the hospital.
Patients can leave the hospital after few hours of stem cell transplantation although in certain cases especially when cells are transplanted Intra-arterial via catheter or surgeries; a patient is advised to stay for a longer duration.
A 24-hour hotline is available for the patients to clear up any doubts and queries that they may face right after their discharge. Our doctors and patient consultants are always available over phone and emails. A patient can easily be in touch with his or her physician, which in return helps us to study their recovery.
Before undergoing this process; a patient must understand that stem cell therapy is an experimental therapy that may fail to work at certain times.
A patient might be refused treatment or the proposed protocol might change depending on the patient’s health condition at the time of procedure.
At Advancells, our primary motive is to offer the best technology available; safety of which has been proven across the world.
Advancells is a strong advocate of greater transparency in medical procedures in general and Stem Cells Procedures in particular. As a part of our effort of bringing transparent procedures to our clients, we provide each client a Third Party Certificate (from an internationally accredited lab) for the cell count and viability of the cells that we are able to process from the autologous cell source of the patient. To view the sample copy of the certificate click here