Stem Cells and the Future of Heart Transplantation

Living reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Allogenic heart transplantation remains the only curative therapy for heart failure. Several strategies have been proposed including cell replacement therapy, engineered cardiac tissues, and novel transplant grafts derived from decellularized organs or xenotransplantation. Cell replacement therapy is the most mature of these technologies, but despite decades of clinical investigation, cardiac cell therapy has yet to enter cardiovascular practice. The major obstacle to replacing lost or injured myocardium remains a reproducible source of electro-, mechano-, and immuno-compatible cardiomyocytes. Noncontractile cells like bone marrow or adult heart derivatives neither engraft long-term nor induce new muscle formation. Correspondingly, these cells offer little functional benefit to infarct patients. In contrast, transplantation of bona fide cardiomyocytes derived from pluripotent stem cells produces direct remuscularization. This new myocardium beats synchronously with the host heart and induces substantial contractile benefits. This chapter reviews the recent progress made toward novel cardiac transplantation strategies with attention to the underlying mechanisms of benefit to appreciate the barriers to cardiac repair and establish a rational path for optimizing therapeutic benefit.


Stem cell Cell therapy Cardiac remuscularization Transplantation 


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Authors and Affiliations

  1. 1.Institute for Stem Cell and Regenerative MedicineUniversity of WashingtonSeattleUSA
  2. 2.Center for Cardiovascular BiologyUniversity of WashingtonSeattleUSA
  3. 3.Department of Medicine/CardiologyUniversity of WashingtonSeattleUSA

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