Page 13 - CUA 2020_Functional Urology

2020 CUA Abstracts

UP-3.20 Miami, FL, United States; Urology, Miller School of Medicine, University
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Baseline measurements of physical function and frailty in pre- of Miami, Miami, FL, United States; Behavioral Medicine Research
transplantation end-stage renal disease patients Center, University of Miami, Miami, FL, United States
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Colin Cavey , Katie Lyman , Rohit Singla , David I. Harriman , Christopher Introduction: There is a growing interest in the use of stem cell therapy
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Y. Nguan 1 (SCT) for erectile dysfunction (ED). Human studies thus far have been
1 University of British Columbia, Vancouver, BC, Canada limited to phase 1/2 trials, with few men with ED receiving SCT. The effect
Introduction: End-stage renal disease (ESRD) is a debilitating chronic of systemically delivered SCT and its effects on ED have not been studied.
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condition that affects roughly 1–2% of the Canadian population. Renal Our aim is to determine the effect of transendocardial injection (TESI) of
transplantation (RT) remains the gold standard therapy, while waitlists SCT on erectile function (EF) using randomized, placebo-controlled data.
exceed five years in some regions. Individuals with ESRD are prone to Methods: We used International Index of Erectile Function (IIEF) scores
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functional decline and muscle-wasting. As a result, poor physical func- collected from men enrolled in three separate randomized controlled tri-
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tion before RT is common and is associated with higher mortality and als: POSEIDON, TAC-HFT, and TRIDENT. All three trials included men
morbidity. This work proposes a set of baseline measures as a tool to with ischemic cardiomyopathy undergoing TESI of SCT or placebo via
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assess physical functional status of preoperative RT recipients. cardiac catheterization. Followup was one year. IIEF data was collected
Methods: Renal transplant preassessments (n=36) at Vancouver General at baseline and at multiple time points in each trial. We investigated EF
Hospital were recruited and all patients completed a supervised baseline over time based on cell dose, cell source (autologous versus allogenic),
physical assessment to assess cardiovascular health and frailty, includ- cell type (mesenchymal stem cells vs. bone marrow mononuclear cells),
ing a six-minute walk test, 30-second sit to stand, and the Fried frailty as well as comparing men who received SCT to placebo.
score evaluation. Results: A total of 36 men were identified from the three trials with com-
Results: Thirty-six recipients were identified with a mean age of 57 years plete IIEF data. Eight men received placebo injection and 28 received SCT.
(range 27–80, M:F 42%:58%) Mean distance covered during the six- Median age was 66.5 years. Comorbidities were similar among all men.
minute walk test was 360.0 meters for elderly males (68% of the expected Analysis was performed on men with ED, defined by an IIEF-EF score of 24
distance of a healthy individual) and 281.0 meters for elderly females or less. In the placebo and SCT group, median IIEF-EF score was 5 (1–8)
(64% of normal). Mean distance for non-elderly males was 367.7 meters and 5 (1–15) at baseline, and was 3.5 (3–5.8) and 7 (1–18) at 12 months,
(60% of normal) and 381.4 meters for non-elderly females (69% of nor- respectively (p>0.05). None of our subgroup analyses revealed a change in
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mal). Mean number of repetitions for the 30-second sit to stand was 9.4
for elderly and 13.2 for non-elderly. There was no significant difference
in Fried frailty score between age groups. The mean Frailty score for both UP-3.22. Table 1. Clinical and demographic characteristics
groups was 2.0, which is considered intermediately frail (2/5). of the pooled stem cell group and placebo group in men
Conclusions: Preliminary results indicate potential utility for quantifying with ED
baseline cardiovascular health, physical functioning, and frailty status
in this comorbid population. Ongoing data collection and assessment Placebo Stem cell
will enable fine-grained baselines for different demographics, including n=8 (%) therapy
gender, ethnicity, age, and body mass index. This work is the first step n=28 (%)
towards initiating a prehabilitation exercise intervention. Age ± SD 65±11.75 65±10.94
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Effect of transendocardial stem cell injection on erectile function Urolithiasis 0 1 (3.6)
in men with cardiomyopathy: Results from the TRIDENT, Baseline IIEF-EF (IQR) 5.5 (1.5– 8.5) 5 (1.3–14)
POSEIDON, and TAC-HFT trials 3-month IIEF-EF (IQR) 6.5 (2.5– 20) 6 (1– 20.8)
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Jesse Ory , Russell G Saltzman , Ruben Blachman-Braun , Simon
Dadoun , Darcy L DiFede , Courtney Premer , Barry Hurwitz , Gavin 6-month IIEF-EF (IQR) 6 (1.5– 16) 4 (1–21)
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Langille , Joshua M Hare , Ranjith Ramasamy 3 12-month IIEF-EF (IQR) 3.5 (3– 5.8) 7 (1.5 20)
1 Urology, Dalhousie University, Halifax, NS, Canada; Interdisciplinary Data pooled from POSEIDON, TRIDENT, and TAC-HFT.
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Stem Cell Institute, Miller School of Medicine, University of Miami,
S76 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)