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Intracoronary bone marrow cell application for terminal heart failure in children

Published online by Cambridge University Press:  13 February 2012

Stefan Rupp ,
Christian Jux ,
Halvard Bönig ,
Jürgen Bauer ,
Torsten Tonn ,
Erhard Seifried ,
Stefanie Dimmeler ,
Andreas M. Zeiher  and
Dietmar Schranz
Stefan Rupp
Affiliation:
Pediatric Heart Center, Justus-Liebig University Giessen, Giessen, Germany
Christian Jux
Affiliation:
Pediatric Heart Center, Justus-Liebig University Giessen, Giessen, Germany
Halvard Bönig
Affiliation:
German Red Cross Blood Service Baden–Württemberg–Hessen and Institute for Transfusion Medicine and Immunohaematology, Goethe University Frankfurt, Frankfurt, Germany
Jürgen Bauer
Affiliation:
Pediatric Heart Center, Justus-Liebig University Giessen, Giessen, Germany
Torsten Tonn
Affiliation:
German Red Cross Blood Service Baden–Württemberg–Hessen and Institute for Transfusion Medicine and Immunohaematology, Goethe University Frankfurt, Frankfurt, Germany
Erhard Seifried
Affiliation:
German Red Cross Blood Service Baden–Württemberg–Hessen and Institute for Transfusion Medicine and Immunohaematology, Goethe University Frankfurt, Frankfurt, Germany
Stefanie Dimmeler
Affiliation:
Department of Cardiology, Goethe University Frankfurt, Frankfurt, Germany
Andreas M. Zeiher
Affiliation:
Department of Cardiology, Goethe University Frankfurt, Frankfurt, Germany
Dietmar Schranz*
Affiliation:
Pediatric Heart Center, Justus-Liebig University Giessen, Giessen, Germany
*
Correspondence to: Professor Dr D. Schranz, MD, Pediatric Heart Center, Justus-Liebig University, Feulgenstrasse 12, 35385 Giessen, Germany. Tel: 049 641 9943461; Fax: 049 641 9943469; E-mail: Dietmar.Schranz@paediat.med.uni-giessen.de
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Abstract

Introduction

In spite of tremendous progress in the medical and surgical treatment of children with congenital heart disease and dilated cardiomyopathy achieved during the past few decades, for some children a heart transplant remains the only option. Clinically relevant benefits of intracoronary injection of autologous stem cells on cardiac function and remodelling have been demonstrated in adult patients with acute myocardial infarction. Experience with autologous stem cell therapy in children with severe congenital or acquired pump failure is limited to a small number of case reports.

Method and results

Between 2006 and 2010, nine severely ill children were treated with intracoronary infusion of autologous bone marrow-derived mononuclear cells as part of a compassionate therapy in our centre. No procedure-related unexpected adverse events occurred. There was one patient on extracorporeal membrane oxygenation who died of haemorrhage unrelated to the procedure; three patients proceeded to heart transplantation once a donor heart became available. The other five patients showed an improvement with respect to New York Heart Association classification (greater than or equal to 1), brain natriuretic peptide serum levels, and ejection fraction.

Conclusion

Similar to adults, intracoronary injection of autologous bone marrow cell is technically feasible and safe for children. On the basis of our data, we propose to perform a pilot study for children with congestive heart failure, to formally assess the efficacy of intracoronary autologous bone marrow cell therapy.

Keywords

Cardiac regenerationheart insufficiencydilated cardiomyopathy
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 5 , 13 September 2012 , pp. 558 - 563
Copyright
Copyright © Cambridge University Press 2012

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Footnotes

*

Institute for Transfusion Medicine, German Red Cross Blood Donor Service East, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.

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