{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:55:57Z","timestamp":1790592957741,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perianal fistulas are a debilitating complication of Crohn's disease, frequently refractory to conventional medical and surgical therapy. Stem cell\u2013based interventions, particularly mesenchymal stem cells (MSCs), have emerged as a promising therapeutic alternative, yet long\u2010term outcomes remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Web of Science, PubMed, Embase, Scopus, and the Cochrane Library were searched through September 1, 2024. Studies evaluating stem cell or stem cell\u2010derived products for Crohn's disease\u2013associated perianal fistulas with \u226512\u2009months' follow\u2010up were included. Efficacy outcomes included clinical and radiological healing and recurrence; safety outcomes encompassed adverse events, infections, malignancies and mortality. Meta\u2010analyses were conducted using random\u2010effects models. The primary analysis was restricted to RCTs, while observational and early\u2010phase studies were analysed separately. An exploratory pooled estimate across all study designs was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen studies comprising 750 patients were included, with follow\u2010up ranging from 12\u2009months to 4\u2009years. In the primary analysis of RCTs, the pooled long\u2010term healing rate was 59% (95% CI, 51%\u201367%), with no observed heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). Observational and early\u2010phase studies demonstrated broadly comparable healing rates but with greater heterogeneity and a higher risk of bias. An exploratory pooled analysis across all studies yielded an overall healing rate of 63% (95% CI 55%\u201370%), although this estimate should be interpreted with caution due to differences in study design. Safety profiles were favourable across studies. No treatment\u2010related deaths and no definitively therapy\u2010associated malignancies were identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stem cell\u2010based therapy is a safe and effective long\u2010term treatment option for Crohn's disease associated perianal fistulas, achieving durable closure in approximately two\u2010thirds of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70636","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:00:58Z","timestamp":1790589658000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term clinical outcomes of stem cell\u2010based interventions in Crohn's\u2010related perianal fistula: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7519-0561","authenticated-orcid":false,"given":"Mohammadreza","family":"Heidari","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy Alborz University of Medical Sciences  Karaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1360-7321","authenticated-orcid":false,"given":"Amir Mohammad","family":"Azizpour","sequence":"additional","affiliation":[{"name":"School of Medicine Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2635-2659","authenticated-orcid":false,"given":"Maryam","family":"Rayatpisheh","sequence":"additional","affiliation":[{"name":"Digestive Disease Research Center, Digestive Disease Research Institute Tehran University of Medical Sciences  Tehran 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