Inclusion Criteria
1. Men and women 18-75 years of age who have undergone an ileal pouch anal anastomosis at least 6 months prior who have developed a clinical diagnosis of Crohn's disease of the pouch as determined by a combination of clinical symptoms, pouchoscopy with biopsy, enterography.
2. Single and multi-tract (up to 2 internal and 3 external openings) fistula tract arising from the ileal pouch, ileal anal anastomosis, or anal canal distal to anastomosis that travels to the perianal skin, perineal body, or vagina. Subjects with fistulas that arise from the pouch, anastomosis, or anal canal distal to the anastomosis will both be included in enrollment. a. Acceptable internal openings and tract locations for the fistula to arise from include the ileal pouch body, the pouch anal anastomosis, and the anal canal distal to the anastomosis.
b. Acceptable external openings and tract locations for the fistula to arise from include the perianal skin, perineal body, and/or the vaginal wall.
3. Concurrent Crohn's related therapies with stable doses (\>3 months) corticosteroids, 5-ASA drugs, immunomodulators, anti-TNF therapy, anti-integrin and anti-interleukin are permitted.
4. Failed oral antibiotic therapy -any oral antibiotic that has been attempted and has not been effective for fistula closure.
5. Have failed conventional medical therapies described above, defined as a lack of response to systemic immune suppression (e.g. azathioprine, methotrexate, 6-mercaptopurine) or biologic (e.g. anti-TNF, anti-integrin, anti-interleukin) therapies to treat fistulizing CD for at least 3 months
6. Competent and able to provide written informed consent
7. Ability to comply with protocol.
Exclusion Criteria
1. Change in medical management for CD in the previous 2 months or changes anticipated in the next 2 months
2. Daily use of prednisone of greater than 20 mg per day
3. Clinically significant medical conditions within the six months before administration of vBM-MSCs: e.g. myocardial infarction, active angina, congestive heart failure or other conditions that would, in the opinion of the investigators, compromise the safety of the subject.
4. Specific exclusions;
* HIV
* Hepatitis B or C
5. History of cancer including melanoma (with the exception of localized skin cancers) within 1 year prior to treatment
6. Investigational drug within thirty (30) days of baseline
7. Pregnant or breast feeding or trying to become pregnant
8. Contraindications to MR evaluations: e.g. pacemaker or magnetically active metal fragments, claustrophobia
9. Unwilling to agree to use acceptable contraception methods during participation in study
