Limbal Stem Cell Transplantation Without Tissue Culture and Reducing Stem Cell Use (SLET: Simple Limbal Epithelial Transplantation)

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       Improve patients' quality of life as SLET surgical success results revealed that patients had a higher quality of life enhanced by becoming more independent and capable of caring for themselves without the assistance of others andTo increase the number of medical practitioners specializing in stem cells, CRST and RCOPT develop ophthalmology workshops on "Stem Cell Treatment for LSCD" and validate cornea specialists who can perform SLET surgery.  Reproduce the SLET surgery around the country to regional surgeons to lessen rural residents' difficulty obtaining transportation to Bangkok for treatment.

In Thailand, SLET surgery has a high success rate with impressive results in the recovery of limbal stem cell deficiency (LSCD). It helped patients improve their quality of life and become more self-sufficient. Furthermore, the SLET surgery helped the country's reputation by publishing research papers in prestigious international journals. Despite the lack of specialized equipment and a high-tech laboratory, the SLET surgery resulted in significant medical cost savings and an economic cost benefit.

The result from measurable and indicated performance

Patient Impact

  • From 2007 to 2022, patients were treated with the SLET technique in 49 eyes, with 36 eyes (73.5%) achieving success. -  This technique improved patients' quality of life by allowing them to live everyday lives while contributing to the well-being of their families and others, whereas the patients were unable to find appropriate treatment.
  • The SLET result was equal to the stem cell culture, former procedure, and had better results from some diseases stem cell culture.

 

Cost-effectiveness

  • By avoiding using complex laboratory technology, laboratory and personnel costs were reduced.
  • Saved millions of baht in development costs in advanced technology laboratories, which used to cost millions of baht per lab and required highly skilled personnel to maintain.
  • Tissue culture time and cost savings.
  • Saved more than five million baht in stem cell culture costs in treating 50 patients.
  • Saved time because patients can have surgery immediately instead of waiting 15 days for stem cell cultivation.

Note: The cost of stem cell cultures such as Holoclar in foreign countries is 80,000 GBP or approximately 3,520,000 Baht.

Implement to other ophthalmologists and the general public

  • Presented SLET research at Queen Sirikit National Convention Center at the 34th Congress of Asia Pacific Academic of Ophthalmology (APAO 2019) on March 5th - 9th, 2019.
  • Held a press conference on "Siriraj successful in limbal stem cell treatment for the first time in Thailand" on June 4th, 2019.
  • Many international journals have published my research papers.
  • SLET workshop meetings were organized for Thai and neighboring countries' ophthalmologists by inviting specialized guest speakers to lecture, perform surgery, and perform Wet Lab.
  • The SLET technique allows ophthalmologists in any hospital to perform surgery without the need for specialized equipment or a stem cell culture laboratory.
  • Distribute the procedure from medical institutes to university hospitals such as Ramathibodi Hospital, Thammasat University Hospital, Phramongkutklao Hospital, Mahanakorn Hospital, Chiang Mai, Srinakarin Hospital, Khonkaen, Rajavithi Hospital, Songklanagarind Hospital, and so on.

 

Cooperation with the Cornea and Refractive Society of Thailand (CRST) and the Royal College of Ophthalmologists of Thailand (RCOPT)

  • Proposed SLET surgery to Thailand's Medical Council to be validated as a standard procedure for patients with limbal stem cell deficiency treatment via stem cell therapy, the second type of bone marrow transplantation.
  • SLET surgery was proposed to National Health Security Office (NHSO) for approval of healthcare rights so that patients receiving limbal stem cell treatment can access all services.
  • Create a workshop curriculum for ophthalmologists on "stem cell treatment for limbal stem cell deficiency" and award a certificate to cornea specialists.

 

Further studies 

  • The validated success of SLET has resulted in two additional ongoing studies in Thailand, one focusing on patient quality of life and the other on the therapeutic efficiency of various stem cell types.
  • Beginning in 2020, a three-year study on the quality of life of Thai patients.
  • A 1-2 year comparative study on the efficacy of different stem cell types transplantation in Thailand, beginning in 2022.                    
    Improvement of Health Care Welfare Systems
  • Distributed the SLET technique to surgeons across the country to reduce the difficulty of transporting patients from rural areas to Bangkok.
  • Collaboration with CRST and RCOPT to propose to the Medical Council of Thailand that SLET surgery be validated as the standard treatment, to NHSO that rights be approved, and to organize SLET workshops for ophthalmologists.
Partners/Stakeholders

Siriraj Limbal Stem Cell Transplantation Team 2022

  • Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Department of Ophthalmology, Golden Jubilee Medical Center, Mahidol University
  • Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University
  • Department of Biomedical Engineering, Faculty of Engineering, Mahidol University
  • Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University
  • Department of Ophthalmology, Faculty of Medicine, Thammasat University
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Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University
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