#4880 SUCCESSFUL LIMB SALVAGE IN A CHALLENGING PATIENT ON DIALYSIS BY IMPLANTATION OF AUTOLOGOUS PERIPHERAL BLOOD MONONUCLEAR CELLS: A CASE REPORT

Abstract Background and Aims Peripheral arterial disease (PAD) is an extremely common condition in patients with End-Stage Renal Disease (ESRD) on dialysis. Concomitant comorbidity such as diabetes may be associated complex vascular dysfunction, ESRD itself a recognized risk factor for PAD leading to non healing ulcers lower limb amputation, which occurs high rate of [1]. Despite improvement endovascular techniques extremity revascularization, the incidence salvage among dialysis remains poor. Furthermore, amputation these higher mortality rates [2], addition important social economic implications. In this Case Report, emergent therapy approach was applied aiming 74 years old female patient hemodialysis suffering from critical ischemia diabetic foot infection, otherwise candidate major after ineffective angioplasty Negative Pressure Wound Therapy (NPWT). Method After surgical debridement ischemic lesion, innovative therapeutic [3] performed. It consisted implantation, perilesional area affected limb, concentrate autologous peripheral blood mononuclear cells (PBMNC) taken 120 ml patient, by using selective filtration separation system. This procedure managed operating room repeated three times at intervals 15 days each other. Since concomitant osteomyelitis ischemical under treatment, it 2-dose regimen weekly Dalbavancin, reaching infection control. The followed twice week 7 months regular medications. Results treatment approach, granulation tissue improved gradually, obtaining complete wound healing. toes gangrene occurs, necessary, but rescue successfully reached. Conclusion implantation PBMNC resulted foot. has not been described literature dialysis, despite patients. seems very promising therapy, potential modify natural history no-options complications, terms overall survival rates. thorough validation, reported management could considered similar cases.