Autologous peripheral blood stem cell transplantation for myocardial regeneration: a novel strategy for cell collection and surgical injection.
OBJECTIVE
Bone-marrow and peripheral blood-derived stem cells can be used as stimulators of myogenesis and angiogenesis. We describe an original technique for collection and surgical intramyocardial injection of peripheral blood-derived stem cells.


METHODS
Stem cells are mobilized from the bone marrow by means of subcutaneous administration of Lenogastrim (Granocyte 34 [Aventis Pharma, Milan, Italy]) for 4 days. Then the day before the operation the peripheral blood-derived stem cells are collected by means of apheresis and processed in order to obtain the CD 133+ cells. Cells are injected into the myocardium in a beating heart in order to induce angiogenesis locally or myogenesis, or both. When necessary, off-pump coronary artery bypass grafting is previously accomplished.


RESULTS
Thus far we have investigated 4 patients (3 patients who have received off-pump peripheral blood stem cell injection and coronary bypass grafting through median sternotomies, and 1 patient who underwent cell transplant alone through a minimally-invasive transdiaphragmatic approach). No complications were noted at a mean of 4 months after surgery.


CONCLUSIONS
This novel method of peripheral bone marrow stem cell collection and intramyocardial injection seems to be safe, feasible, and reproducible. However, there is need of further evidence to definitely assess safety issues and clinical results.
Pompilio
Giulio
G
Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milano, Italy. giulio.pompilio@ccfm.it
Cannata
Aldo
A
Peccatori
Fedro
F
Bertolini
Francesco
F
Nascimbene
Angelo
A
Capogrossi
Maurizio C
MC
Biglioli
Paolo
P
D000071916:AC133 Antigen; D015703:Antigens, CD; D047549:Coronary Artery Bypass, Off-Pump; D023903:Coronary Restenosis / Q000628:therapy; D005240:Feasibility Studies; D006023:Glycoproteins / Q000032:analysis; D006321:Heart / Q000502:physiology; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000628:therapy*; D010455:Peptides / Q000032:analysis; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D010865:Pilot Projects; D012038:Regeneration; D013249:Sternum / Q000601:surgery; D014182:Transplantation, Autologous
D000071916:AC133 Antigen; D015703:Antigens, CD; D006023:Glycoproteins; D010455:Peptides