Autologous Myoblast Sheet Implantation for Severe Heart Failure

Abstract

Human cardiac regeneration therapy has been performed by using various sources of stem cell. Myoblasts and bone marrow cells have been injected for patients with ischemic cardiomyopathy in our clinical trial and improved cardiac performance. We had examined the efficacy of stem cell therapy using tissue engineered sheet technique compared to needle injection. This technique has advantages such as the ability for treatment to large area, and less invasive for host heart such as lethal arrhythmia. In vivo, implantation of autologous myoblast sheet had improved cardiac function of ischemic or dilated cardiomyopathy models using rat, hamster, canine and porcine models. We also showed that myoblast sheets provided various factors inducing angiogenesis, hematopoietic cell recruitment and anti-apoptosis, following anti-remodeling. Thus, after approved by IRB of our institution, we have started the clinical trial of myoblast sheet implantation for DCM patients, and assessed the feasibility and efficacy for the first patient. In this patient, any sequelae including arrhythmia have not occurred after implantation, and the cardiac function showed recovery. Furthermore, we have investigated several improvement of this technology for the layered implantation for ischemic heart, for right heart failure, and another cell source to construct the sheet. Thus, stem cell sheet implantation could be safe and eligible as cardiac regeneration therapy.