Information For Physicians

Regenexx Procedure: Information for Health Care Providers

Stem cells are heavily advertised all over the Internet.  RSI recognizes the need for significant basic science information on stem cell therapies so that consumers and medical professionals can make informed decisions.

What type of stem cells are these?

These are the patient’s own (autologous) bone marrow derived mesenchymal stem cells (MSC’s).  They are isolated in the lab from a bone marrow aspirate.

Is this the same as BMAC or a bone marrow concentrate prepared at the bedside in a centrifuge?

No.  BMAC is a very dilute stem cell mixture which contains mostly stem cells that help to make new blood products.  Only about 1 in 100,000 to 1 in 500,000 of these cells is a stem cell capable of orthopedic tissue repair.  RSI first strated experimenting with a more sophisticated form of lab prepared BMAC in 2005 and abandoned it’s use by 2006 when we found it significantly less capable of demonstrating MRI changes indicating repair of orthopedic tissues.

What is the MSC selection procedure?

We use adhesion and multiple culture passages to select a pure MSC population.  These are then culture expanded to achieve a clinically relevant number of cells.

How are the cell grown?

The cells are grown using the growth factors isolated from the patient’s blood platelets (platelet lysate).  The cells are first plated from the bone marrow in a colony forming monolayer culture.  Once colonies form, the cells are transferred to monolayer expansion culture and continually isolated and culture expanded to increasing numbers.

Where are the cells grown?

RSI grows cells in a state of the art, positive pressure cell culture lab.  Cell biologists minimally manipulate cells in laminar flow hoods.  The lab is located in Broomfield, Colorado.

How are the lab practices audited?

RSI contracts with Reglera, a nationally recognized leader in quality standards.  RSI initiates regular site visits by Reglera to check our facility, lab practices, the work of our cell biologists, and equipment.

What are average yields?

A yield is how many cells are produced at the end of the culture period.  The average yield for our patients is between 5-50 million cells with significant biologic variability between patients (meaning some patients can grow slightly more of less than these averages).

What is the cell phenotype being produced by the procedure?

Cell phenotype means the exact type of cell.  With adult stem cells, this is usually defined as the types of markers these cells exhibit on their surfaces.  The most commonly reported markers to determine stem cell phenotype are CD or “Cluster of Differentiation”.  The CD cell marker profile as tested by the University of Colorado Immunology Department is: CD14-, CD29+, CD31-, CD44+, CD59+, CD90+, CD106 weak +, CD166+, CD73+, CD105+.

Can I see MRI’s before and after treatment?

Yes, the Medical Provider Information Brochure contains this information as well as other general information for medical providers.

Does the Regenexx procedure and the physician practice use any third party guidelines for lab safety, clinical practice, and patient tracking?

The physicians at the Regenexx clinic use the ICMS professional guidelines to benchmark their stem cell practice. For more information, on ICMS, click here . We follow these professional guidelines:

1. Stem Cell Lab Practice: We undergo approximately bi-annual audits through Reglera, a nationally known lab best practices organization. We are held to the ICMS lab guidelines. Click here to read the guidelines.  Any problems or issues noted by Reglera are appropriately addressed.

2. Clinical Practice: The doctors at Regenexx adhere to the ICMS clinical guidelines for the safe use of autologous stem cell therapy. For more information, click here.

3. Complications Tracking and Safety Monitoring: We utilize the ICMS re-implantation registry as an non-profit third party to track our patients at set time points. The complaints adjudications system for ICMS follows closely the same system used in HHS studies. Click here to read the study.

We have also published on our complications and safety data (n=227), which is available on-line. Click here to see the study.

 

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