Stem cell therapy as one of temporary measures for management of heart failure and pulmonary hypertension in children

Andis Lacis, Aris Lacis, Inguna Lubaua, Andrejs Erglis

Abstract


Favourable results of experimental studies on animals and several conditions in adult population indicate that bone marrow derived progenitor stem cell (BMPSC) transplantation may play a crucial role. Nevertheless, little is known about possible implementation of the BMPSC transplantation in children, dilated cardiomyopathy and pulmonary hypertension in particular. An increasing understanding of the nature and processes of idiopathic dilated cardiomyopathy and pulmonary arterial hypertension in children, as well as the limited treatment options have led our research towards the use of stem cell transplantation in the management of these patients. We performed intramyocardial BMPSC transplantation in 6 patients (4 months to 17 years) with dilated cardiomyopathy. All patients underwent complete detailed examination before and after the procedure. All patients demonstrated an increase in LVEF and degree of shortening of the left ventricular diameter between end-diastole and end-systole after the procedure. A decreased concentration of natriuretic peptide or LVDd on 2D and 3D echocardiography was observed in 5 and 3 of the 6 patients respectively. Intrapulmonary BMPSC transplantation was performed in two patients (9 and 15 years old) with severe pulmonary hypertension due to uncorrected large ventricular septal defects. Both patients showed improvement in lungs’ vascularization. No serious periprocedural side effects were observed. If applied wisely, the stem cell therapy appears to be a safe and effective way for stabilization of critically ill patients with both severe pulmonary hypertension and idiopathic cardiomyopathy.


Keywords


Pediatrics; stem cells; idiopathic dilated cardiomyopathy; pulmonary arterial hypertension; intramyocardial administration

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References


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