Author/Editor     Domanović, Dragoslav; Sever, Matjaž; Vrtovec, Bojan; Ležaić, Luka; Fettich, Jure; Černelč, Peter; Rožman, Primož
Title     Preparation of autologous CD34+ cells for intracoronary infusion to patients with end-stage dilated cardiomyopathy
Type     članek
Source     Bilten za transfuziologiju
Vol. and No.     Letnik 55, št. 1-2
Publication year     2009
Volume     str. 79-83
Language     eng
Abstract     Background. We have evaluated the results of the mobilization and collection of autologous peripheral blood stem cells (PBSC) as well as the further selection of CD 34+ cells. The autologous CD34+ cell products were prepared for intracoronary infusion to patients with end-stage dilated cardiomyopathy in order to replace damaged cardiomyocytes and to improve their heart function. Methods and Results. In 36 patients with dilated cardiomyopathy, the PBSCs were mobilized by daily subcutaneous injections of granulocyte colony-stimulating factors (G-CSF) and were collected by small volume leukaphereses as mononuclear cell (MNC) fraction. CD34+ cells were positively selected by the immunomagnetic method. CD34+ cell number target was 90 x 106 per one infusion. The median MNC count before mobilization was 2.65 (2.3 - 3.9) x 109/L. After mobilization it increased approximately 2 times to median value of 6.6 (2.3 - 11.7) x 109/L. The median number of CD34+ cells in patients after mobilization was 125.6 (30.2 - 426.1) x 106/L. Leukapheresis product that contained in median 20.1 (10.7 - 37.9) x109 of MNC and 125.6 (30.2 - 426.1) x106 CD34+ cells. Median collection efficiency of the MNC was 38.3 (9.1 - 74.5) % and 51.3 (23.6 - 81.1) % of CD34+ cells. In the median volume 102 (98 - 115) mL of the selected product the median total number of CD34+ cells in was 95 (49.7 - 154.8) x 106. Conclusions. The PBSC mobilization with G-CSF and the collection by leukapheresis are safe and well tolerated procedures for patients with dilative cardiomyopathy. The immunomagnetic selection of CD34+ cells from the collected PBSCs provides high quality final products for secure intracoronary infusion. Cardiomyopathy patients showed lower responsiveness to PBSC mobilization with G-CSF.
Descriptors     HEART FAILURE, CONGESTIVE
CARDIOMYOPATHY, CONGESTIVE
ANTIGENS, CD34
HEMATOPOIETIC STEM CELL TRANSPLANTATION
INFUSIONS, INTRA-ARTERIAL
CORONARY VESSELS
GRANULOCYTE COLONY-STIMULATING FACTOR
LEUKOCYTES, MONONUCLEAR
LEUKAPHERESIS
PHENOTYPE
IMMUNOMAGNETIC SEPARATION
BLOOD TRANSFUSION, AUTOLOGOUS