title: Clinical impact of combined transplantation of autologous skeletal myoblasts and bone marrow mononuclear cells in patients with severely deteriorated ischemic cardiomyopathy.
abstract: OBJECTIVE
  Simultaneous injection of autologous bone marrow cells and skeletal myoblasts has been demonstrated to improve cardiac function in animal models. We evaluated the potential application of this combination cell therapy in patients with severe ischemic cardiomyopathy who required left ventricular assist device (LVAD) implantation.
  
  
  METHODS
  Four patients (age range, 43-69 years) who required LVAD implantation due to severe ischemic cardiomyopathy were studied. Skeletal myoblasts were obtained from the thigh, while bone marrow mononuclear cells were collected and purified at the time of the operation. These cells were directly injected in a serial manner into the damaged myocardium.
  
  
  RESULTS
  No fatal arrhythmias or major complications were observed. The number of injected skeletal myoblasts ranged from 2.7 × 10(7) to 3.0 × 10(8), and their purity ranged from 25% to 96%. Two patients showed decreased brain natriuretic peptide levels and echocardiographic improvements in the transplanted areas, as well as increased perfusion revealed by H(2) (15)O positron emission tomography, of whom one was successfully weaned from LVAD. Histological findings at autopsy of the other patient showed a small amount of skeletal muscle in the injected area. Only marginal improvements were observed in the other two patients.
  
  
  CONCLUSIONS
  Combined cell transplantation is feasible for patients with severe ischemic cardiomyopathy, and functional recovery is anticipated in selected patients.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Taichi
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Sigeru
authors.initials: S
authors.lastname: Miyagawa
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Saito
authors.forename: Naosumi
authors.initials: N
authors.lastname: Sekiya
authors.forename: Hironori
authors.initials: H
authors.lastname: Izutani
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D015331:Cohort Studies; D005240:Feasibility Studies; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D008875:Middle Aged; D032448:Myoblasts, Skeletal / Q000637:transplantation*; D017202:Myocardial Ischemia / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome