Title : Surgical fetal stem cell transplant into heart failure patients: Long-term results at 14 years
Abstract:
Direct myocardial transplant of HFDSCs (human fetal derived stem cells) by open chest surgical procedure was performed in 10 patients with Heart Failure (HF) due to no ischemic, no chagasic dilated cardiomyopathy. All 10 patients survived the operation. At 40 months, the mean (±SD) NYHA class decreased from 3.4 ± 0.5 to 1.33 ± 0.5 (p = .001); the mean EF increased 31%, from 26.6% ± F) 34.8% ± 7.2% (p = .005); and the mean ETT increased 291.3%, from 4.25 minutes to 16.63 minutes (128.9% increase in metabolic equivalents, from 2.46 to 5.63) (p < .0001); the mean LVEDD decreased 15%, from 6.85 ± 0.6 cm to 5.80 ± 0.58 cm (p < .001); mean performance in the 6-minute walk test increased by 43.2%, from 251 ± 113.1 seconds to 360 0 seconds (p = .01); the mean distance increased 64.4%, from 284.4 144.9 m to 468.2 ± 89.8 m (p = .004); and the mean result in the Minnesota test decreased from 71 ± 27.3 to 6 ± 5.9 (p < .001). Six patients survived after 40 months; 5 of them had complete reverse remodeling after 3 months after transplants. The average age at the moment of the transplants was 62 years (s/d 11.6).
Results: The first patient died at 5,4 years for an infection; the second patient died at 7,4 years for heart failure; the third patient died at 8,4 years for heart failure; the fourth patient died at 10 years for heart failure and the fifth patient died at 14,4 years after transplant at the age of 83 for heart failure. The average age at the moment of death was 70 years (s/d12.9). The survival rate at 4 years was 100% (K/M) and at 14 years (25%K/M).
Conclusion: These initial worldwide experiences with the surgical direct transplant of liver fetal stem cells in patients with end-stage HF shows clearly the positive effect in the reverse remodeling of the left ventricle of 50% of the cohort and excellent long-term results in these types of patients opening a new avenue for treating end-stage HF patients without any other option of treatment.
