A 36-year-old man with severe acute kidney injury (AKI) was admitted to Shonan Kamakura General Hospital in Japan. He was diagnosed with refractory hypertension based on a severely elevated blood pressure of 224/116 mmHg and retinal, cardiac, and brain damage revealed by electrocardiogram, fundoscopy, and magnetic resonance imaging, respectively. Although hemodialysis was withdrawn following strict blood pressure control by an angiotensin receptor blocker, severe kidney insufficiency persisted. Therefore, we performed an autologous granulocyte colony-stimulating factor-mobilized peripheral blood CD34-positive cell transplantation. Collected CD34-positive cells were directly infused to both renal arteries. The patient's general condition was unremarkable after intervention, and the serum creatinine level gradually improved to 2.96 mg/dL 23 weeks after cell therapy. Although transient fever and thrombocytosis were observed after intervention, no major adverse events were observed. This patient is the first case in a phase I/II clinical trial of autologous granulocyte colony-stimulating factor-mobilized peripheral blood CD34-positive cell transplantation for severe AKI with a CD34-positive cell dose-escalating protocol (trial number jRCTb030190231).

中文翻译：

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自体粒细胞集落刺激因子动员外周血 CD34 阳性细胞移植成功治疗急性肾损伤：首次人体报告

一名患有严重急性肾损伤 (AKI) 的 36 岁男性被送往日本湘南镰仓综合医院。根据严重升高的 224/116 mmHg 的血压和心电图、眼底镜检查和磁共振成像分别显示的视网膜、心脏和脑损伤，他被诊断为顽固性高血压。尽管在血管紧张素受体阻滞剂严格控制血压后停止了血液透析，但严重的肾功能不全仍然存在。因此，我们进行了自体粒细胞集落刺激因子动员的外周血CD34阳性细胞移植。将收集的 CD34 阳性细胞直接注入两个肾动脉。干预后患者一般情况无异常，血清肌酐水平逐渐改善至2。细胞治疗后 23 周为 96 mg/dL。虽然干预后观察到短暂发热和血小板增多，但未观察到主要不良事件。该患者是自体粒细胞集落刺激因子动员外周血 CD34 阳性细胞移植治疗严重 AKI 的 I/II 期临床试验的首例病例，该试验采用 CD34 阳性细胞剂量递增方案（试验编号 jRCTb030190231）。