Autologous human serum for cell culture avoids the implantation of cardioverter-defibrillators in cellular cardiomyoplasty

Background: Current clinical experience with cellular cardiomyoplasty (using serum bovine-cultivated myoblasts) has demonstrated significant malignant ventricular arrhythmias and sudden deaths in patients. In some ongoing clinical trials the implantation of cardioverterdefibrillator is mandatory. We have hypothesized that contact of human cells with fetal bovine serum results after 3-week fixation of animal proteins on the cell surface, representing an antigenic substrate for immunological and inflammatory adverse events. Methods and Results: Autologous myoblasts were transplanted into infarcted LV in 20 patients (90% males, mean age 62±8 years). Cells were cultivated in a complete human medium during 3 weeks, using the patients' own serum obtained from a blood sample or from plasmapheresis. Injections were performed during CABG (2.1 grafts/pt). All patients had an uneventful recovery. At a mean follow-up of 14±5 months without mortality, no malignant cardiac arrhythmias are reported. LV ejection fraction improved from 28±3% to 52:k4.7% (p = 0.03), and regional wall motion score index (WMSI) from 3.1 to 1.4 (p = 0.04) in the cell-treated segments. Myocardial viability tests showed areas of regeneration. Patients moved from mean NYHA class 2.5 to class 1.2. Conclusions: A total autologous cell culture procedure was used in cellular cardiomyoplasty reducing the risk of arrhythmia. Human-autologous-serum cell expansion avoids the risk of prion, viral or zoonoses contamination. Since patients treated with noncultivated bone marrow cells are free of arrhythmia, the bovine-culture medium seems to be responsible for this complication. Cellular cardiomyoplasty may be efficient to avoid progression of ventricular remodeling and subsequent heart failure in ischemic heart disease

Treatment of heart failure with autologous skeletal myoblasts

The management of patients with heart failure is a daily challenge for cardiologists and cardiac surgeons. Pharmacotherapy, atrio-biventricular resynchronization, myocardial revascularization, valve repair techniques, latissimus dorsi cardiomyoplasty, acorn cardiac support device, heart transplantation and mechanical assist devices do not cover all the needs. The recent progress in cellular and molecular biology allows the development of new therapies for heart failure. Transplantation of Autologous Cells: One of the most innovative consists in the transplantation of autologous ex-vivo expanded cells into the myocardium for heart muscle regeneration. This approach is called “cellular cardiomyoplasty”

Cellular Cardiomyoplasty: Clinical Application

Myocardial regeneration can be induced with the implantation of a variety of myogenic and angiogenic cell types. More than 150 patients have been treated with cellular cardiomyoplasty worldwide, 18 patients have been treated by our group. Cellular cardiomyoplasty seems to reduce the size and fibrosis of infarct scars, limit postischemic remodelling, and restore regional myocardial contractility. Techniques for skeletal myoblasts culture and ex vivo expansion using autologous patient serum (obtained from plasmapheresis) have been developed by our group. In this article we propose (1) a total autologous cell culture technique and procedures for cell delivery and (2) a clinical trial with appropriate endpoints structured to determine the efficacy of cellular cardiomyoplasty

Treatment of heart failure with autologous skeletal myoblasts

The management of patients with heart failure is a daily challenge for cardiologists and cardiac surgeons. Pharmacotherapy, atrio-biventricular resynchronization, myocardial revascularization, valve repair techniques, latissimus dorsi cardiomyoplasty, acorn cardiac support device, heart transplantation and mechanical assist devices do not cover all the needs. The recent progress in cellular and molecular biology allows the development of new therapies for heart failure. Transplantation of Autologous Cells: One of the most innovative consists in the transplantation of autologous ex-vivo expanded cells into the myocardium for heart muscle regeneration. This approach is called “cellular cardiomyoplasty”

Cellular Cardiomyoplasty: Clinical Application

Myocardial regeneration can be induced with the implantation of a variety of myogenic and angiogenic cell types. More than 150 patients have been treated with cellular cardiomyoplasty worldwide, 18 patients have been treated by our group. Cellular cardiomyoplasty seems to reduce the size and fibrosis of infarct scars, limit postischemic remodelling, and restore regional myocardial contractility. Techniques for skeletal myoblasts culture and ex vivo expansion using autologous patient serum (obtained from plasmapheresis) have been developed by our group. In this article we propose (1) a total autologous cell culture technique and procedures for cell delivery and (2) a clinical trial with appropriate endpoints structured to determine the efficacy of cellular cardiomyoplasty