title: Novel regenerative therapy using cell-sheet covered with omentum flap delivers a huge number of cells in a porcine myocardial infarction model.
abstract: OBJECTIVE
  A key challenge to applying cell transplantation to treat severely damaged myocardium is in delivering large numbers of cells with minimum cell loss. We developed a new implantation method using skeletal myoblast (SMB) sheets, wrapped with an omentum flap as a blood supply to deliver huge numbers of SMBs to the damaged heart. We examined whether this method could be used to deliver a large amount of cells to deteriorated porcine myocardium.
  
  
  METHODS
  Cell sheets were obtained by culturing mini-pig autologous SMB cells on temperature-responsive culture dishes. Myocardial infarction was induced by placing an ameroid constrictor around the left anterior descending artery. The mini-pigs were divided into 4 treatment groups (n = 6 in each): cell sheets with omentum, cell sheets only, omentum only, and sham operation. Each animal implant consisted of 30 cell sheets (1.5 × 10(7) cells per sheet). Six 5-layer constructs were each placed on a different area, immediately adjacent to but not overlapping one another, to cover the infarct and border regions.
  
  
  RESULTS
  The new regenerative cell delivery system using SMB sheets covered and wrapped with omentum resulted in (1) a significantly reduced infarct size causing, at least in part, a thin scar with thick well-vascularized cardiac tissue; (2) increased angiogenesis, as determined by a significantly higher vascular density; and (3) improved cardiac function, as determined by echocardiography, compared with the conventional method (SMB sheet implantation).
  
  
  CONCLUSIONS
  This cell delivery system shows potential for repairing the severely failed heart.
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shudo
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyagawa
authors.forename: Satsuki
authors.initials: S
authors.lastname: Fukushima
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Saito
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Teruo
authors.initials: T
authors.lastname: Okano
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D004195:Disease Models, Animal; D005260:Female; D032448:Myoblasts, Skeletal / Q000637:transplantation*; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D009206:Myocardium / Q000473:pathology*; D018919:Neovascularization, Physiologic; D009852:Omentum / Q000098:blood supply / Q000601:surgery*; D020127:Recovery of Function; D012038:Regeneration; D013318:Stroke Volume; D013524:Surgical Flaps; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous; D016277:Ventricular Function, Left