Autologous stem cell therapy for hypoplastic left heart syndrome: Safety and feasibility of intraoperative intramyocardial injections

The role of regenerative therapy in the treatment of right ventricular failure: a literature review

“…Most of our knowledge regarding the role of stem cells in the treatment of RV failure has been gleaned from studies in various experimental animal models of increased RV afterload, such as pulmonary artery banding (PAB), monocrotaline, or Sugen 5416/hypoxia models. To date, bone marrowderived mononuclear cells [30][31][32][33][34][35][36], umbilical cord blood-derived mononuclear cells [37][38][39][40], cardiospherederived cells, and cardiac progenitor cells [27,28,[41][42][43][44] have been tested in animal models as well as in human trials to address RV failure (Tables 1 and 2). Beneficial effects have been reported following administration of each of these cell types, but preclinical studies have lacked uniform experimental design (i.e., have varied route of administration, number of cells delivered, animal models or disease context, etc.…”

“…Investigators at the Mayo Clinic have formed a collaboration to build an HLHS consortium, currently comprised of twelve centers across North America. In their phase I clinical trial testing intramyocardial injection autologous umbilical cord blood-derived mononuclear cells, the Mayo team did not find any adverse effects of cell therapy, although no improvements in RV function were reported either [40]. Allogenic MSCs have been clinically investigated in ischemic and non-ischemic cardiomyopathy in adult patients [49].…”

Commentary: Cross my heart and stick a needle in it—I hope to live

“…In this issue of the Journal, Burkhart and colleagues 1 report results of a phase I trial designed to assess safety and feasibility of epicardial injections of umbilical cord bloodderived mononuclear cells in 10 patients with hypoplastic left heart syndrome at the time of stage II (Glenn) palliation. 1 If we accept the premise that delivery of the right cell types in the right amount to the young infant myocardium will provide durable and clinically relevant benefit, then this work is important.…”

“…In this issue of the Journal, Burkhart and colleagues 1 report results of a phase I trial designed to assess safety and feasibility of epicardial injections of umbilical cord bloodderived mononuclear cells in 10 patients with hypoplastic left heart syndrome at the time of stage II (Glenn) palliation. 1 If we accept the premise that delivery of the right cell types in the right amount to the young infant myocardium will provide durable and clinically relevant benefit, then this work is important. Burkhart and colleagues 1 have developed and refined a method of umbilical cord blood harvest and processing that provides a reliable product at the time of the Glenn palliation-a significant achievement resulting from years of determined hard work.…”

“…1 If we accept the premise that delivery of the right cell types in the right amount to the young infant myocardium will provide durable and clinically relevant benefit, then this work is important. Burkhart and colleagues 1 have developed and refined a method of umbilical cord blood harvest and processing that provides a reliable product at the time of the Glenn palliation-a significant achievement resulting from years of determined hard work. Overall, the success rate of producing this autologous source was 80%; reaching more than 90% when more than 35 mL of cord blood was available.…”