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STATE-OF-THE-ART PAPER

Potential Hazards and Technical Considerations Associated With Myocardial Cell Transplantation Protocols for Ischemic Myocardial Syndrome

Department of Cardiology, Rabin Medical Center, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Manuscript received April 3, 2006; revised manuscript received June 5, 2006, accepted June 19, 2006.

^_* Reprint requests and correspondence: Dr. Ran Kornowski, Department of Cardiology, Rabin Medical Center, 39 Jabotinsky Street, Petach Tikva, Israel 49100 (Email: rkornowski{at}clalit.org.il).

Cell transplantation has recently emerged as a promising therapeutic approach to ischemic cardiomyopathy syndromes. Clinical studies suggest important benefits, including improved myocardial perfusion and function. The safety profile so far seems to be high overall, although the technique may harbor several adverse effects, such as ventricular arrhythmia, acceleration of atherosclerosis or restenosis, and induction of ischemic events. Multiple factors may affect the safety of cell infusion into the diseased heart, including the mode of delivery, the type of cells injected, compound characterization, and the heart status, function, and arrhythmogenic potential. Also, any adjunctive treatment used to enhance cellular homing and/or transdifferentiation increases the likelihood of unexpected local or systemic toxicity or side effects. In the present review, we discuss the potential hazards of this novel treatment and its relationship to technical considerations.

Abbreviations and Acronyms   G-CSF = granulocyte colony-stimulating factor   GM-CSF = granulocyte-macrophage colony-stimulating factor   VEGF = vascular endothelial growth factor

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