APPROACH OF AUTOLOGOUS INTRAMYOCARDIAL PERIPHERAL BLOOD PROGENITOR CELL TRANSPLANTATION IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY

Background. Autologous peripheral blood progenitor cells transplantation (PBPCT) in patients with ischemic cardiomyopathy (ICMP) who lack potentialities of standard treatment options seems to have been perspective.

Aims. The main purpose of this study was decreasing of mortality and improving the quality of life of patients with ICMP by developing and application in routine clinical practice the approach of intramyocardial autologous PBPCT in combination with optimal drug therapy.

Materials and methods. Patients with diagnosed ICMP were divided into two groups: autologous transplantation PBPCT in combination with optimal drug therapy (group 1, n=29) versus optimal drug therapy alone (group 2, n=31). Patients of the group 1 received granulocyte colony-stimulating factor (G-CSF) at a dose 5 мg/kg for 5 days. Leukapheresis was performed on the fifth day. Isolation of mononuclear cells (MNC) was provided by Ficoll-Paque 1.077 g/ml density gradient centrifugation. Intramyocardial transplantation was performed by NOGA XP Navigation System and Myostar catheter. Follow up occurred at 1, 3, 6, 12 and 18 months.

Results. During the follow up there was noticed that the maximum effect of intramyocardial transplantation develoed after 6 months after the transplantation. LVEF increased by an average by (6±3)% and improvement of local and global contractility observed. After 18 months-follow-up increasing of survival was noticed.