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Ann Thorac Surg 2001;71:1724-1733
© 2001 The Society of Thoracic Surgeons

Current review

Myocyte transplantation for myocardial repair: a few good cells can mend a broken heart

Reida M. El Oakley, MDa, Oon Cheong Ooi, FRCSa, Ariff Bongso, PhDb, Magdi H. Yacoub, FRCSc

a Department of Cardiac Surgery, The National University Hospital of Singapore, Singapore
b Department of Obstetrics & Gynecology, The National University Hospital of Singapore, Singapore
c Division of Cardiothoracic Surgery, Imperial College School of Medicine at The National Heart and Lung Institute, London, England, United Kingdom

Address reprint requests to Dr El Oakley, Department of Cardiac Surgery, National University Hospital of Singapore, 5 Lower Kent Ridge Rd, Singapore 119074
e-mail: eloakley{at}hotmail.com

Cell transplantation is a potential therapeutic approach for patients with chronic myocardial failure. Experimental transplantation of neonatal and fetal cardiac myocytes showed that the grafted cells can functionally integrate with and augment the function of the recipient heart. Clinical application of this approach will be limited by shortage of donors, chronic rejection, and because it is ethically contentious. By contrast skeletal myoblasts (satellite cells) are abundant and can be grafted successfully into the animal’s own heart even after genetic manipulation in vitro. Functional integration of myoblasts, however, is hampered by the lack of intercellular gap junction communication and the difference in excitation-contraction coupling between skeletal and cardiac myocytes. In experimental studies several other cell types have been used to augment cardiac function. In this review we discuss the published results of myocyte transplantation with emphasis on potential sources of cells, the ethics of using donor embryonic and fetal cardiomyocytes, genetic transformation of skeletal myoblasts for myocardial repair, and the functional benefits of cell transplantation to the failing heart.




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