Several experimental studies have introduced Schwann cell
transplantation as a means of recovery in animal models of
spinal cord injury (SCI). The reported promising results together with the availability of autologous sources for Schwann cells indicate Schwann cell
transplantation as a possible treatment for SCI. To address the safety and feasibility concerns we report 1-year follow-up of four patients aged between 22 and 43 years who had stable chronic (28-80 months)
spinal cord injury at mid-thoracic level and treated with autologous Schwann cell
transplantation. Purified Schwann cells used for
transplantation were acquired from autologous sural nerve and cultured without the use of any specific mitogenic or
growth factors. The patients were evaluated by means of American
Spinal Injury Association (ASIA) criteria, sphincter, sexual function and Magnetic Resonance Imaging assessments for 1 year after
transplantation. None of the patients were found to have any adverse effects indicating transfer of
infection, neurological deterioration or other related clinical problems. Of the four patients, only one patient with incomplete SCI showed motor and sensory improvement 1 year after
transplantation with extensive and continuous rehabilitation. All the four patients experienced transient
paresthesia or increased
muscle spasm after
transplantation. Magnetic Resonance (MR) images of the patients did not show any visible changes or pathological findings after 1 year. This preliminary report shows that autologous Schwann cell
transplantation is generally safe for the selected number of SCI patients but it does not prove beneficial effects. Further safety and outcome studies are recommended.