Biomaterials for Cardiac Cell Transplantation

Regenerative therapy for heart failure remains a significantly unmet need in the global medical community. One of the leading causes of heart failure is myocardial infarction (MI), which occurs when the blood supply to a part of the heart is interrupted, causing a loss of cardiac muscle and its replacement with noncontractile scar. Over time, this results in a process of remodeling that leads to left ventricular (LV) dilation and LV dysfunction. Novel approaches to the treatment of this condition are needed to improve the quality of life and the survival of patients who suffer from post-MI LV dysfunction and congestive heart failure (CHF). It has been proposed that, of these treatment options, transplantation of stem cells may significantly improve regional contractile and LV function, and have the best chance of improving the clinical outcome. However, most stem cell transplantation studies have yielded modest results, with either necrotic/apoptotic loss or displacement by the heart's contractions—a universal result for the vast majority of donor cells within days of transplantation. Collectively, these observations suggest that the success of cell transplantation for cardiac tissue regeneration will hinge upon enhanced cell survival, subsequent promotion of their functional integration into existing tissue, and temporal expansion in transplant size. Accordingly, biomaterials are now being explored to address these issues, creating prosurvival systems for stem cell transplantation composed of natural, synthetic, and biosynthetic hybrid materials.