Our position regarding the alert given to Costa Rican population about stem cell treatment by the Costa Rican College of Physicians and Surgeons

A series of reports have recently appeared in electronic, national, and international media sources, citing a warning by the College of Physicians and Surgeons of Costa Rica, about abuses that may be taking place in our country by unscrupulous clinics using stem cells. According to news sources, some of these clinics are offering “miracle therapies” to patients, without any clinical or scientific data to support the therapies. 

The authors point out that these treatments could create health risks, such as infection or hereditary diseases. However, the articles also claim that the College of Physicians and Surgeons do not have any registered or recognized specialties in the field of cell therapy or stem cell therapy, and do not have any governmental regulations in Costa Rica. 

For these reasons, the article provides the following quote: “The College of Physicians recommends to patients carefully study the information provided and to take advise before undergoing these unauthorized therapies. It is important to be aware of what you are taking to avoid exposing oneself to procedures and interventions without scientific evidence, carried out by unscrupulous individualsThe president of The College of Physicians, Andrés Castillo, said. 

I am a medical physician duly registered with the Costa Rican College of Physicians and Surgeons (professional card No. 8606), with a professional and clinical practice of more than 11 years, and I am a passionate student of stem cell treatments. I have the following specialized training and certifications; 1. A fellowship in stem cells by the American Academy of Anti-Aging Medicine, United States of America 2. Theoretical and practical training in techniques, procedures, manufacture and processing of stem cells from adipose tissue, bone marrow and peripheral blood (PRP) REGENTECH, United States of America, Manila, Philippines 3. Certification by the American Board of Anti-Aging and Regenerative Medicine, Chicago, Illinois, United States of America, among others. I would like to share with you my point of view regarding the recent news reports and statement by the Medical Association: 

(1) First, I want to congratulate the Costa Rican College of Physicians and Surgeons, for alerting the Costa Rican people about the risks involved in undergoing treatments at clinics that do not have the necessary experience and scientific knowledge to successfully perform those treatments. We believe it is very important for the College and the national legislation to establish clear guidelines in this area, especially around the requirements that must be met by clinics and doctors offering these treatments. 

(2) It seems important and fundamental to inform the people, especially potential patients, about the position of the College of Physicians and Surgeons, specifically the Prosecutor’s Office of the College, regarding the benefits of stem cell treatments and clarify which treatments are and which treatments are not endorsed by the College. Therefore, with the corresponding authorization I am transcribing some of the important conclusions of this Collegial Dependency, in one of its resolutions: 

“… In recent years, cell therapy, especially with adult stem cells, has made great strides in regenerative medicine. Research on this type of cells, has generated great hope for the cure of multiple diseases, they seem to be better than embryonic stem cells … “ 

 “… There are endless researches pointing the benefits of adult stem cells in the treatment of several pathologies. Many of these studies have culminated in clinical applications in diseases such as: cardiovascular; neurological, degenerative, diabetes mellitus, bone lesions … “ 

Based on these premises, considering the potential use of stem cell treatment, the Prosecutor’s Office of the College concludes the following: 

The Prosecutor’s Office of the College of Physicians and Surgeons of Costa Rica, supports the use of hematopoietic stem cells obtained from bone marrow and umbilical cord to treat patients with blood, metabolic or immune system diseases. The analysis of duly accredited medical and scientific studies conclude that this procedure is a therapeutic alternative of great benefit for the restoration of health and has shown positive results not only in the laboratory tests, but also in the clinic presented by the patient. Additionally, it has been duly evidenced that during the implementation of this procedure, there is absolute respect for the principle of beneficence of the patient, since the benefits that could be obtained from it are greater than the risks to which the patient should be submitted… 

The Office of the College of Physicians and Surgeons of Costa Rica does not endorse the use of therapies or procedures in which embryonic stem cells are used. This, since an interference must be made in the normal development of the embryo to extract the cells, which is excessively risky for the health of the fetus, threatens its life and it´s detrimental to the rights that are intrinsic to every human being … “(Official letter FJG-2405-15, from the Office of the Prosecutor of the College of Physicians and Surgeons of Costa Rica). 

(3) The Costa Rican people must be informed about the Executive Decree (No. 39986-S)“Authorization for regenerative therapies with adult stem cells”, which regulates the way in which the clinics that are going to provide treatments with stem cells must operate, as well as the requirements of the physicians providing the authorized therapies. 

Through this Executive Decree, issued by the Presidency of the Republic and the Ministry of Health towards the end of 2016, the specific requirements to authorize regenerative therapies with adult stem cells were established. For example, article 2 of that normative text prescribes that: “Transplantation of progenitor cells obtained from peripheral blood or transplantation of hematopoietic cells obtained from umbilical cord blood, do not require authorization when indicated for the treatment of myeloid leukemia, acute lymphoid, lymphocytic or chronic myeloid leukemia, Hodgkin’s or non-Hodgkin’s lymphoma, severe aplastic anemia, paroxysmal nocturnal hemoglobinuria, immune system diseases, some hemoglobinopathies and hereditary metabolic diseases, as well as myeloma multiple and in certain solid tumors. ” 

Therapies whose adult stem cells are exposed to more than minimal manipulation, under the fulfillment of certain requirements are also authorized (indicated in article 3 of the Decree). 

Adult stem cell therapies for autologous use only, having regenerative purposes and where the cells are exposed to minimum manipulation, are authorized under the fulfillment of certain requirements (indicated in article 4 of the Decree). 

This statement is made specifically to address the concerns mentioned in the recent reports that have generated false impression. The authors lead on to believe that in Costa Rica, none of the stem cell treatments are regulated, authorized, or backed by scientific evidence. For example, the report from La Nación cited: “With the exception of the use of stem cells for bone marrow transplantation, the rest of the treatments do not have authorization from the College of Physicians and Surgeons, because there is no scientific evidence about its results, neither in Costa Rica nor in the rest of the world. ” 

If we read what it is stated by the Prosecutor’s Office of the College of Physicians and the Decree No. 39986-S, we conclude, that this statement is wrong. It is important and it is my professional responsibility to provide accurate information to the people of Costa Rica and to potential patients.   

(4) Finally, it is important to inform the general community that our clinic strictly follows the requirements made by Executive Decree No. 39728-S- and has the authorization of Health services, by the Regional Office of the Rector of the Health of Escazú, according to the official letter 471-17, of July 18, 2017, whereby, in its operative part, it is expressly stated: “Therefore: The Operating Health Permit is granted to Establishment: Stem Cells Transplant Institute. Activity: General Medical Consultation Services or Specialties. Type of Risk: B, ISIC Classification: 8620-1. Legal representative: Leslie Manrique Mesén Martínez “In this way, we can continue providing the best health service for the benefit of our valued patients. 

Stem Cells Transplant Institute
Work Team