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G. Pellegrini, M. De Luca; Long term follow up of multicenter clinical study with cultured limbal stem cells . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3940.
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Purpose: The purpose of this study is to evaluate long term results of cultured limbal stem cells application and molecular markers predicting the clinical outcome. Methods: Stem cells were obtained from the limbus of contralateral eye of patients suffering from severe limbal stem cell deficiency and cultivated onto a fibrin substrate. The limbal epithelium obtained was screened for keratins, p63 and 14–3–3 sigma expression. Results: 83 patients were treated and evaluated, on long term follow up, in nine clinical ophtalmology departments within the Italian territory . Several patients underwent subsequent perforating keratoplasty and markers were evaluated on the removed cornea at least 1 year after transplantation. 71% of patients had positive clinical outcome with recovery of corneal surface functions, 26% had partial or total failure of transplantation for inflammatory reaction and bleeding and we found 3% of unexpected failure. In the last group, careful analisys of cells isolated from the original biopsy revealed very low to absent level of p63 , and low percentage of cells negative for keratin 3 and keratin19. Serial subcultivation of these cells revealed a shorter life span ence lower proliferative potential as compared to the other cell strains. The epithelium obtained from these cells failed the long term corneal reepithelialisation. Conclusions: 59 patients out of 83, with a follow up ranging between 2 years and 6 years, showed long term stability of transplanted corneal epithelium with recovery of corneal surface functions and suggest a time dependent distribution of transplanted stem cells on the ocular surface Ophtalmologists participating to the study
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