A patient that needs an evaluation for stem cell implant will initially be seen by a physician specialized in his disease; a neurologist for Parkinson’s, stroke or cerebral hypoxia, a cardiologist for heart diseases, an endocrinologist for diabetes, a vascular surgeon for peripheral vascular disease, a gastroenterologist for hepatic cirrhosis or an ophthalmologist for retinal diseases.

If after this evaluation, he is considered a candidate, additional tests will be needed for further evaluation.

For patients with cerebral disease:

• Magnetic Resonance Imaging (MRI) with perfusion, diffusion and spectroscopy studies.

• Laboratory tests: Complete blood count, glucose, urea, creatinin, coagulation tests VDRL & HIV Tests and urinalysis.

• Psychological evaluation and pre-surgical cardiovascular evaluation risk.

• Scales for disease severity and quality of life.

For Parkinson’s disease patients, the implant can not be done in patients:

• Over 80 years old

• With cardiac, hepatic or renal insufficiency.
• With cancer.
• With any infection, acute or chronic.
• Medullar insufficiency.

If the patient is still a good candidate a final interview will take place, where any questions and doubts will be cleared, explaining the pro's and con's (benefits and risks). This is will all be filmed, and an informed consent form has to be signed.

STEM CELL IMPLANT

There are three well defined phases:

BONE MARROW EXTRACTION

This phase is performed by a medical team of hematologists and clinical pathologists.

The patient will be lightly sedated, on a monitored conscious sedation, he will experience no pain.

400cc of bone marrow are extracted. This will be performed maintaining strict asepsis and lasts approximately 40 minutes.

STEM CELL PURIFICATION AND CONCENTRATION

With minimum manipulation, hematologists and clinical pathologists purify and concentrate the stem cells from the bone marrow extraction, obtaining 120cc. This phase lasts from 2 to 3 hours.

ENDOVASCULAR STEM CELL IMPLANT

Using vascular catheterism techniques stem cells are implanted. Emphasis is taken in order to place of implant in to the affected area, oreferably where the perforating arteries originate. This phase lasts 2 to 3 hours. The vascular catheterism is performed through the common femoral artery at the groin.