First Results of using Stem Cell Transplantation for Pediatric Patients in Case of Dilated Cardiomyopathy

Introduction. Dilated cardiomyopathy is a serious disorder of the myocardium in pediatric age. Conservative therapy is limited and lethal outcome observed in one third of patients within a year. Bone marrow derived progenitor cell transplantation is becoming a promising method of treatment in adult population and there is ground to believe there are perspectives in pediatric cardiology. Aim of the Study. We present the first results of bone marrow cell transplantation in case of dilated cardiomyopathy for six patients at age four months to seventeen years. Materials and methods. We did the six Bone marrow derived progenitor cell (BMCs) intramycardial transplantations. Five to 30 mililiters of bone marrow were aspirated from iliac bone. Seventeen to 90 million BMCs were isolated and as suspension of physiologic saline given to patients by intramyocardial punction. Every patient underwent repeated examination every two month. Results. Six months following bone marrow derived progenitor stem cell intramyocardial transplantation we observed increase of ejection fraction in 4 patients, decrease of dilatation echocardiographycally and cardiothoracic ratio (CTR) at chest x-ray; decrease of the stage of heart insufficiency clinically from class IV to I-II(NYHA). Conclusions. We see the intramyocardial administration of bone marrow cells proved to be technically feasible and safe, also the procedure does not need for expensive technical equipment. The bone marrow transplantation improves the patients clinical situation and physical measurements. Our method might be used for the stabilization of the patient to get the time for further treatment.