{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:17:51Z","timestamp":1784513871026,"version":"3.55.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T00:00:00Z","timestamp":1644192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>From 30 to 70% of patients with Crohn's disease (CD) may develop perianal fistulas during their lifetime. The medical and surgical management of this complication is challenging, and its treatment still gives unsatisfactory results. However, recent studies on adipose-derived mesenchymal stem cells have proven their anti-inflammatory and immuno-modulatory potential, representing a new promising tool in the treatment of such stubborn disease. We report our initial experience with three patients who had recurrent perianal CD treated with local infiltration of stem cell darvadstrocel (Alofisel). All the patients had a long history of perianal disease refractory to multiple medical and surgical treatments. The preoperative workup included transperineal ultrasound (TP-US), pelvic MRI, and colonoscopy that ruled out active proctitis in all the patients. The post-treatment follow-up included clinical assessment at 1, 3, and 6 months with repeated MRI and TP-US at 6 months. At 6 months, 2 patients had a clinical response despite radiological persistence of fistula tracts, while one patient presented perianal fistula recurrence complicated by perianal abscess. Although our experience is limited to 3 patients and a short follow-up, our results confirm that darvadstrocel injection is a safe procedure, with a good clinical response in most of the patients, but that it apparently had no effect on the anatomical modification of the fistula tracts. Long-term results, with a rigorous assessment of anatomical lesions, are still needed to support the promising data of the literature.<\/jats:p>","DOI":"10.3389\/fsurg.2022.834870","type":"journal-article","created":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T05:16:01Z","timestamp":1644210961000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Stem Cell Injection for Complex Refractory Perianal Fistulas in Crohn's Disease: A Single Center Initial Experience"],"prefix":"10.3389","volume":"9","author":[{"given":"Francesco","family":"Colombo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cammarata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Baldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Rizzetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bondurri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Carmagnola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Gridavilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Maconi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Ardizzone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Danelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1097\/MOG.0000000000000751","article-title":"Multidisciplinary management of perianal Crohn's disease","volume":"37","author":"Abushamma","year":"2021","journal-title":"Curr Opin Gastroenterol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s13287-020-02095-7","article-title":"Efficacy of stem cells therapy for Crohn's fistula: a meta analysis and systematic review","volume":"12","author":"Cao","year":"2021","journal-title":"Stem Cell Res Ther."},{"key":"B3","doi-asserted-by":"publisher","first-page":"764","DOI":"10.3390\/cells8070764","article-title":"Mesenchymal stem cells for perianal Crohn's disease","volume":"8","author":"Carvello","year":"2019","journal-title":"Cells."},{"key":"B4","article-title":"Injection of mesenchymal stem cells (darvadstrocel) into perianal fistula of Crohn's disease- a video vignette","author":"Fathallah","year":"2021","journal-title":"Colorectal Dis J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1398","DOI":"10.1056\/NEJM199905063401804","article-title":"Infliximab for the treatment of fistulas in patients with Crohn's disease","volume":"340","author":"Present","year":"1999","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1155\/2005\/269076","article-title":"Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology","volume":"19","author":"Silverberg","year":"2005","journal-title":"Can J Gastroenterol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1097\/DCR.0b013e31825228b0","article-title":"The spectrum of perianal Crohn's disease in a population-based cohort","volume":"55","author":"Eglinton","year":"2012","journal-title":"Dis Colon Rectum."},{"key":"B8","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.dld.2007.07.154","article-title":"The natural history of perianal Crohn's disease","volume":"39","author":"Ingle","year":"2007","journal-title":"Dig Liv Dis."},{"key":"B9","doi-asserted-by":"publisher","first-page":"4821","DOI":"10.3748\/wjg.v24.i42.4821","article-title":"Burden and outcomes for complex perianal fistulas in Crohn's disease: Systematic review","volume":"24","author":"Panes","year":"2018","journal-title":"World J Gastroenterol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/S0140-6736(16)31203-X","article-title":"Expanded allogeneic adipose-derived mesenchymal stem cells (Cx601) for complex perianal fistulas in Crohn's disease: a phase 3 randomised, double-blind controlled trial","volume":"388","author":"Pan\u00e9s","year":"2016","journal-title":"Lancet."},{"key":"B11","doi-asserted-by":"publisher","first-page":"3643","DOI":"10.3748\/wjg.v27.i24.3643","article-title":"Stem cell injection for complex anal fistula in Crohn's disease: a single-center experience","volume":"27","author":"Schwandner","year":"2021","journal-title":"World J Gastroenterol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.3390\/life11111133","article-title":"Current overview on the use of mesenchymal stem cells for perianal fistula treatment in patients with Crohn's disease","volume":"11","author":"W\u0142odarczyk","year":"2021","journal-title":"Life (Basel)."},{"key":"B13","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1093\/ecco-jcc\/jjz180","article-title":"ECCO guidelines on therapeutics in Crohn's disease: medical treatment","volume":"14","author":"Torres","year":"2020","journal-title":"J Crohns Colitis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"97","DOI":"10.5500\/wjt.v8.i4.97","article-title":"Review of stem cells as promising therapy for perianal disease in inflammatory bowel disease","volume":"8","author":"Dailey","year":"2018","journal-title":"World J Transplant."},{"key":"B15","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1097\/01.MIB.0000436274.95722.e5","article-title":"Transperineal perineal ultrasound versus magnetic resonance imaging in the assessment of perianal Crohn's disease","volume":"19","author":"Maconi","year":"2013","journal-title":"Inflamm Bowel Dis."}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.834870\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,7]],"date-time":"2022-02-07T05:16:04Z","timestamp":1644210964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.834870\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,7]]},"references-count":15,"alternative-id":["10.3389\/fsurg.2022.834870"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2022.834870","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,7]]},"article-number":"834870"}}