Feasibility and Safety of Intra-Coronary Bone Marrow Mononuclear Cell Transplantation in ST Elevation Myocardial Infarction Patients
Suphot Srimahachota MD*, Smonporn Boonyaratavej MD*, Pairoj Rerkpattanapipat MD**, Somjai Wangsupachart MD**, Monravee Tumkosit MD**, Udomsak Bunworasate MD***, Thayapong Na Nakorn MD***, Tanin Intragumtornchai MD***, Pawinee Kupatawintu RN*****, Sunisa Pongam RN*, Aem-orn Saengsiri RN*, Mantana Pothisri RN**, Yeesoon Sukseri RN*, Tanorm Bunprasert MD****, Taworn Suithichaiyakul MD*
Affiliation : * Division of Cardiology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand ** Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand *** Division of Hematology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand **** Department of Ear Nose Throat, King Chulalongkorn Memorial Hospital, BAngkok, Thailand ***** Blood Bank, Thai Red Cross Society, Bangkok, Thailand
Background : Stem cell transplantation is a potential treatment to improve left ventricular ejection fraction
(LVEF) after ST elevation myocardial infarction (STEMI). However, technique and mode of transplantation,
type of cells, number of cells, and when to transplant are still unknown.
Objective : To determine the feasibility and safety of bone marrow mononuclear cell (BMC) intra-coronary
transplantation and 6-months results in patients with STEMI.
Material and Method: After successful percutaneous coronary intervention (PCI) in STEMI patients who did
not have flow re-established within 12 hours and poor LVEF (less than 50%) by echocardiography were
enrolled. Bone marrow aspiration of 100 cc was performed in the morning. After cell processing for 3 hours,
the suspension of BMC about 10 cc were infused to infarcted area using standard PCI technique. Balloon
occlusion for 3 minutes was performed during cell infusion. Cardiac magnetic resonance imaging was used to
determine LVEF, scar volume and LV volume before and 6 months after transplantation.
Results : Five patients were enrolled between May and August 2006. Duration of STEMI before transplantation
ranged from 18 days to 14 years. Total amount of BMC ranged from 67 x 106 to 335 x 106. Number of CD 34+
and CD 133+ cells were approximation to be 0.7 x 106 to 7.7 x 106 and 0.01 x 106 to 3.04 x 106. LVEF was
increased from 36.4 at baseline to 43.3 at 6-month. NT pro-BNP level was decreased from 1105 ng/ml at
baseline to 288 pg/ml at 6-month. No complications such as chest pain, no re-flow phenomenon, ventricular
arrhythmia, or hypotension was detected during the procedure.
Conclusion : Intra-coronary BMC transplantation in patients with STEMI in our center is feasible and safe.
LVEF was slightly improved; however, a randomized controlled study is needed.
Keywords : Intracoronary, Bone marrow mononuclear cell transplantation, ST elevation myocardial infarction
