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Stem Cell Diagnosis and Evaluation

Explore evaluation processes used to determine suitability for stem cell treatments.

The journey toward autologous stem cell transplant or therapy begins with a comprehensive consultation.

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The Roadmap to Regeneration

The Diagnostic Trajectory

Regenerative medicine is powerful, but it is not a magic wand that works for everyone. The success of Stem Cell Therapy depends 50% on the quality of the cells and 50% on the Selection of the Patient.

At Liv Hospital, we operate on a principle of “Radical Honesty.” We do not offer stem cell therapy to patients whose conditions are too advanced to respond, or whose underlying health would prevent the cells from working. Before a single cell is harvested, you undergo a comprehensive “Regenerative Potential” Assessment.

This diagnostic phase is designed to answer three critical questions:

  1. Is the tissue alive enough to be saved? (e.g., Is there any cartilage left to regrow?)
  2. Is your body healthy enough to support repair? (e.g., Is your inflammation too high?)
  3. What is the correct dose? (Do you need 20 million cells or 100 million?)

By using advanced imaging, functional testing, and biomarkers, we create a personalized roadmap. If we believe standard surgery (like a knee replacement) would give you a better result, we will tell you. We measure our success by your outcome, not by the number of procedures we perform.

Orthopedic Evaluation

For joint pain, an X-ray is often insufficient. It shows bones, but it misses the soft tissues—cartilage, meniscus, and ligaments—that stem cells target.

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High-Resolution MRI

Hematological Analysis

We use 3-Tesla MRI scanners to grade your injury with precision.

  • Cartilage Mapping: We look for “full-thickness” defects.
    • Ideal Candidate: Kellgren-Lawrence Grade 2 or 3. This means there is still some cartilage remaining (“islands” of healthy tissue) that stem cells can latch onto and expand.
    • Poor Candidate: Grade 4 (“Bone-on-Bone”). If the cartilage is completely gone and the bones are rubbing together, stem cells have no scaffold to build upon. In this case, we recommend Robotic Joint Replacement.
  • Bone Marrow Edema: We look for bright spots in the bone (bruising). Stem cells are incredibly effective at treating these painful lesions.
  • AVN Staging (Ficat Classification): For Avascular Necrosis of the hip, we must catch it in Stage 1 or 2. Once the femoral head has collapsed (Stage 3/4), the shape is permanently deformed, and stem cells cannot reshape bone.
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Gait Analysis

Hemoglobin Electrophoresis and HPLC

Sometimes the MRI looks bad, but the patient walks fine. Sometimes the MRI looks okay, but the patient limps severely.

  • The Lab: You walk on a pressure-sensitive treadmill. Cameras track your joint angles.
  • The Insight: We identify why your knee wore out. Is it because your foot collapses inward (pronation)? Is your hip weak?
  • The Plan: If we inject stem cells but don’t fix your walking pattern, the new tissue will just wear out again. We prescribe custom insoles or physical therapy alongside the injection to ensure long-term success.

Systemic Health Screening

Prenatal Diagnosis

Stem cells are the “seeds.” Your body is the “soil.” If the soil is toxic (high inflammation, uncontrolled sugar), the seeds won’t grow.

The “Regenerative Panel” Blood Test

Before therapy, we check specific biomarkers:

  • HbA1c (Blood Sugar): High sugar levels “candy-coat” stem cells (glycation), making them sluggish and ineffective. If your A1c is >8%, we will work with our Endocrinologists to lower it before the procedure.
  • CRP and ESR (Inflammation): If your body is fighting a massive systemic infection or flare-up (e.g., active Rheumatoid Arthritis), the stem cells will be consumed by the inflammation rather than fixing the joint. We may use medication to “cool down” the system first.
  • Platelet Count: If we are planning PRP (Platelet-Rich Plasma) therapy alongside stem cells, we need to know you have enough healthy platelets to release growth factors.

Infection Screening (Safety First)

We screen every patient for blood-borne viruses (HIV, Hepatitis B/C, Syphilis).

  • Why? Even though we are using your own cells, processing them in the lab carries a risk if the blood is infected. To protect our GMP facility and other patients’ samples, we cannot process active viral blood in the main clean room.

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Aesthetic and Dermatological Analysis

For anti-aging and hair loss, we move beyond “mirror checks” to digital quantification.

Trichoscopy (Digital Hair Analysis)

For hair loss patients.

  • The Tool: A microscopic camera that magnifies the scalp 50x–200x.
  • The Count: We measure hair density (hairs per cm²) and hair shaft thickness (miniaturization).
  • The Assessment: We determine if the follicles are Atrophic (dead) or Dormant (sleeping). Stem cells can wake up dormant follicles, but they cannot resurrect dead ones. This prevents patients with scarring alopecia (like Lichen Planopilaris) from wasting money on a treatment that won’t work.

VISIA™ Skin Analysis

For facial rejuvenation.

  • The Scan: A multispectral imaging system that scans your face.
  • The Metrics: It measures wrinkles, UV damage (spots), pore size, and vascularity (redness) objectively.
  • The Baseline: This gives us a “Day 0” score. We repeat the scan 3 and 6 months after stem cell therapy to prove the increase in collagen and reduction in age spots scientifically.

The "Cell Count" Decision

One of the biggest differences between Liv Hospital and a standard clinic is that we count your cells. Diagnosis determines the dose.

Flow Cytometry

After harvesting your tissue (fat or marrow), we take a sample to our GMP Lab.

  • The Test: We use a laser-based machine to count the cells and check their “markers” (CD90, CD73, CD105). This proves they are true Mesenchymal Stem Cells (MSCs).
  • The Viability: We confirm that >95% of the cells are alive.
  • The Dose Calculation:
    • Mild Knee Pain: Might need 20–30 million cells.
    • Systemic Autoimmune Disease: Might need 100+ million cells via IV.
    • Hair Loss: Might need a concentrated dose of 5 billion Exosomes.
    • Evaluation guides this precision.

Tumor and Genetic Screening

Stem cells release Growth Factors. These are powerful stimulants. If there is a hidden cancer in the body, growth factors could theoretically make it grow faster.

  • Oncology Clearance: We ask all patients >50 years old for recent cancer screening records (Mammogram, PSA, Colonoscopy). If you have a history of cancer, we require a “Clearance Letter” from your oncologist stating you have been remission for at least 5 years.
  • Genetic Screening: For pediatric cases (like Autism), we ensure the child has had a full genetic workup first. Stem cells cannot fix a missing gene (like in Down Syndrome or DMD), although they may help with symptoms. We manage parental expectations strictly.

The Multidisciplinary Council

For complex cases, the decision is not made by a single doctor. It is a team effort.

  • The Ortho-Regenerative Board: An Orthopedic Surgeon, a Sports Medicine Doctor, and a Stem Cell Biologist review your MRI. They debate: Is surgery better? Or will stem cells work?
  • The Aesthetic Council: A Plastic Surgeon and a Dermatologist evaluate if you need a Facelift (structural fix) or Stem Cells (skin quality fix). Often, the answer is a combination.

The Logistics of Evaluation (For International Patients)

We know you have limited time. We streamline the “Go/No-Go” process.

  • Remote Review (Before You Fly): You upload your MRI/X-rays and medical reports to our secure portal. Our specialists review them for free to give a preliminary “Candidate / Non-Candidate” opinion. This saves you from flying to Turkey only to be told “No.”
  • Day 1 On-Site:
    • 09:00: Blood draw (Infection/Inflammation panel).
    • 10:00: New MRI or Ultrasound (if previous ones are old).
    • 13:00: Consultation with the Lead Physician.
    • 15:00: Final Decision. If “Go,” tissue harvesting can be scheduled for the next morning.

FREQUENTLY ASKED QUESTIONS

Do I need a biopsy for diagnosis?

No. For orthopedic or aesthetic conditions, we rely on non-invasive imaging (MRI, Ultrasound) and blood tests. A biopsy is only needed if we suspect a suspicious lesion (like a tumor) that needs to be ruled out before treatment.

For a preliminary opinion, yes. But for a final decision, an MRI is usually required. An X-ray only shows bone. Stem cell therapy targets cartilage, tendons, and ligaments—tissues that are invisible on X-ray. If you don’t have a recent MRI (within 6 months), we will perform one at Liv Hospital.

We pride ourselves on ethical practice. If your knee is “bone-on-bone,” we will recommend Robotic Knee Replacement. If your hair follicles are dead, we will recommend a Hair Transplant. We will always offer the treatment that has the highest statistical chance of success for your specific anatomy.

Stem cells are very sensitive to their environment. High blood sugar (Hyperglycemia) creates a toxic, inflammatory environment that can kill the injected stem cells or make them dormant. Controlling your sugar before the procedure protects your investment.

Most private insurance companies cover the diagnostic portion (MRI, Doctor Consultation, Blood Tests) as standard medical care. However, the stem cell therapy itself is often considered “experimental” or “aesthetic” and is usually self-pay. Our international team can help clarify your coverage.

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