Bone marrow cell transplantation in clinical perspective

The deficit in left ventricular performance in an ischemically damaged heart is characterized by depletion of functioning cardiomyocytes. The problem is accentuated by the inadequate intrinsic repair mechanism of the heart. Recent progress in regenerative medicine has paved way for an outside intervention to support the limited on-going reparative process in the heart through transplantation of cells with myogenic and/or angiogenic potential. The functional plasticity of bone marrow derived stem cells has been exploited for cardiac repair. The early experiences in proof-of-concept animal studies and phase-1 clinical trials have been encouraging and suggest the safety, feasibility and potential of this approach. We critically review the literature in depth to elucidate the progress in this field together with discussion of the problems and controversies that need to be addressed in order to fully exploit the potential of bone marrow stem cell transplantation with clinical relevance.