Regional Limb Perfusion Of The Equine Distal Limb With Stem Cells: Lessons Learned From In Vivo Tracking Of Tc99m-HMPAO Labeled Cells
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Cave Creek Equine Surgical and Imaging Center, United States
ABSTRACT
The presented work is based on a body of literature that has attempted to evaluate the technique of regional limb perfusion (RLP) of mesenchymal stem cells (MSC) in the equine lower limb. Published evidence shows that intra-vascular perfusion of stem cells can promote tissue healing through cell homing to injured sites. Therefore, local cell perfusion could be very relevant in the equine foot where intra-lesional injection is challenging and many soft tissue injuries in the equine foot carry a poor prognosis. Initial work documented that both intra-arterial (IA) and intra-venous (IV) RLP of the distal limb using a pneumatic tourniquet result in MSC persistence in perfused tissues, whereby IA perfusion showed more reliable cell distribution to the pastern and foot area. A time dependent accumulation of MSCs was identified with IA RLP, which also showed better distribution and uptake than the IV RLP.
However, a tourniquet for IA perfusion produced arterial thrombosis and is therefore unsuitable for clinical use. Comparing IA injection through the median artery without a tourniquet and IV RLP performed through the lateral palmar digital vein are both safe and reliable methods for administration of MSCs to the equine foot in the anesthetized patient. However, IV RLP performed in the standing horse was less efficient than when performed under general anesthesia. In contrast the IA technique showed better distribution (under GA) and is therefore clinically preferred. Also, intra-arterial injection of MSC at the level of the median artery can be performed in standing horses and successfully distribute MSCs to the equine foot, and therefore, this is currently the preferred stem cell perfusion technique in horses.
AUTHOR BIOGRAPHY
Dr. Martin Vidal, BVSc, MS, PhD started his horse career as a teenager on the racetrack in Munich and is today an equine veterinary specialist double-boarded by the American Colleges of Veterinary Equine Surgery as well as Sport Medicine and Rehabilitation. Dr. Vidal is also one of the pioneers in the area of stem cell research and its therapeutic application.
Dr. Vidal began his undergraduate and graduate education at the University of Wisconsin and then completed his veterinary training in 2000 at the University of Liverpool. Dr. Vidal started his career in a British private practice, the Minster Equine Veterinary Clinic and in Australia where he completed his internship at the Goulburn Valley Equine Hospital. During his internship Dr. Vidal frequently treated injured horses with bone marrow transfers, an early form of equine regenerative therapy for tendon and ligament injuries. This experience motivated Dr. Vidal to pursue further post-graduate work in stem cell biology at Louisiana State University, where he also completed his residency in equine surgery.
Dr. Vidal was among the first to publish on equine stem cell research and in 2004, he worked with the LSU veterinary clinical faculty to establish one of the first university-based stem cell services in the country. Dr. Vidal’s work was awarded by the American Association of Veterinary Clinicians and the Grayson-Jockey Club Research Foundation, Inc., and eventually recognized by the University California-Davis Veterinary Medical Hospital, which extended Dr. Vidal a faculty position to advance their own efforts in stem cell therapy. Through his clinical and research work at UC Davis from 2008 to 2014, Dr. Vidal and his colleagues helped to advance the understanding of equine stem cell biology and application methods of regenerative therapy for tendon and ligament injuries in the horse. Dr. Vidal has frequently presented on equine regenerative medicine at national and international scientific and veterinary conferences as well as in varying equestrian communities and has published in both equine and human research journals.
Dr. Vidal draws on his academic background as well as his deep passion for the horse to work with his clients to find the most effective treatments and rehabilitation programs. Dr. Vidal’s primary clinical interests focus on equine sport medicine and surgery and in particular lameness evaluation, imaging and equine orthopedic diseases. His surgical emphasis lies in orthopedic, minimally invasive as well as upper respiratory procedures.
Dr. Vidal serves on the Veterinary and Research Committees of the American Endurance Ride Chapter (AERC) and is an FEI veterinarian for the endurance discipline. He resides in the Rio Verde area of North Scottsdale with his family and loves to train Karate and play polo.
Acknowledgements
Drs Mathiew Spriet, Larry D. Galuppo, Jan M. Trela, Albert Sole, Betsy Vaughan, Dori L. Borjesson, Erik R. Wisner,
Robert J. Brosnan, Tara A. Hembrooke, Mrs. Kerstien A. Padgett, School of Veterinary Medicine, University of
California, Davis CA, USA.
Drs. Mark C. Rick, Sabine Buechler, Alamo Pintado Medical Center, Los Olivos, CA, USA
Keywords:
Perfusion,
Stem Cells,
Technetium,
distribution,
Veterinary,
Equine
Conference:
First and Second Conference on Current Veterinary Practices, Meldert-Lummen and Evergem, Belgium, 5 Mar - 26 Mar, 2016.
Presentation Type:
Oral Presentation
Topic:
Current Veterinary Practices
Citation:
Vidal
MA
(2016). Regional Limb Perfusion Of The Equine Distal Limb With Stem Cells: Lessons Learned From In Vivo Tracking Of Tc99m-HMPAO Labeled Cells.
Front. Vet. Sci.
Conference Abstract:
First and Second Conference on Current Veterinary Practices.
doi: 10.3389/conf.FVETS.2016.01.00001
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Received:
27 Jan 2016;
Published Online:
29 Jan 2016.
*
Correspondence:
DVM, PhD. Martin A Vidal, Cave Creek Equine Surgical and Imaging Center, Phoenix, AZ, 34705, United States, cavecreekequinesc@gmail.com