07.03.19

A new and promising treatment uses the patient’s own fat cells to heal complex fistulas related to Crohn’s disease.

Doctors and researchers from Aarhus University Hospital and Aarhus University have developed a new method which may potentially benefit many patients suffering from the inflammatory bowel disease Crohn’s. The first results from the new treatment have just been published in the scientific journal Gastroenterology.

Crohn’s Disease is a chronic inflammatory bowel disease. Some patients suffering from Crohn’s Disease develop so-called anal fistulas, typically developing from an abscess in the rectum.

- Approximately one in four patients with Crohn’s Disease will develop complex anal fistulas, which may impact negatively on their quality of life, says Lilli Lundby, Consultant at Department of Surgery, Pelvic Floor Unit at Aarhus University Hospital.

Simple and cheap method

Normally, this type of fistulas are treated with a combination of medicine and surgery, but the fistulas will only heal in half of the patients. Injecting cultivated stem cells is also a possibility, but this method has proved expensive and time-consuming. The doctors at Aarhus University Hospital have therefore tried to inject the patient’s own fresh fat tissue.

- The method is very simple. You harvest the patient’s own fat tissue, typically from the stomach region, and inject the fresh tissue in and around the fistua tract and close the internal opening of the fistula. The method is cheap as the injected fat tissue cells are not cultivated.

Promising results

The results after treatment of the first 21 patients have just been published in the journal Gastroenterology. The results show that 57% of the patients achieved complete fistula healing six months after treatment with the patient’s own fat cells - by both clinical examination and magnetic resonance imaging. An additional 19% of the patients experienced a considerable relief of symptoms. The treatment is safe and only a few complications are reported.

- The results are very promising. The treatment is cheap as we use the patient’s own fat. It is a very cost-effective way of solving a problem causing severe distress for many patients with Crohn’s Disease, says Lilli Lundby.

The results of this research project will now be tested in a larger randomised study, which is planned to start in April 2019.

Important with room for development

Jørgen Schøler Kristensen, Chief Medical Officer at Aarhus University Hospital stresses the importance of making room for development of new treatment methods at the hospital.

- This research shows that our own staff can develop both cheaper and more effective treatments than existing methods. It is very important that we at a university hospital promote the development of new clinical practice, says Jørgen Schøler Kristensen.

Behind the research result:

• Study design: Retrospective study.
• Collaborators: Department of Surgery, Pelvic Floor Unit, Department of Hepatology and Gastroenterology, Department of Radiology at Aarhus University Hospital
• Finansing: No external financings
• Conflicts of interest: None
• Publication: Published in the scientific journal Gastroenterology
• Link to original article: https://doi.org/10.1053/j.gastro.2019.02.005

Facts:

• Crohn's Disease is a chronic inflammatory bowel disease, which may affect the entire gastro-intestinal tract
• Common symptoms of Crohn's Disease are abdominal pain, diarrhoae, weight loss, fever and fatigue
• Some patients with Crohn's Disease have symptoms around the rectal area such as infection, abscesses or fistulas
• Fistulas are caused by infection in the perianal area. It is a connection between the anal canal/rectum and the skin (the vagina in women)
• Fistulas result in discharge of pus and faeces and may cause infection and pain.

Further information:

Lilli Lundby, Consultant and PhD, Department of Surgery, Pelvic Floor Unit, Aarhus University Hospital, Tel.: +45 28 30 93 72, e-mail: lilli@dadlnet.dk

Jørgen Schøler Kristensen, Chief Medical Officer, Aarhus University Hospital, Tel.: +45 20 16 32 01, e-mail: joerkris@rm.dk