Heart cells with regenerative potential from pediatric patients with end stage heart failure: A translatable method to enrich and propagate

Background. Human cardiac-derived progenitor cells (hCPCs) have shown promise in treating heart failure (HF) in adults. The purpose of this study was to describe derivation of hCPCs from pediatric patients with end-stage HF. Methods. At surgery, discarded right atrial tissues (hAA) were obtained from HF patients (n = 25; hAA-CHF). Minced tissues were suspended in complete (serum-containing) DMEM. Cells were selected for their tissue migration and expression of stem cell factor receptor (hc-kit). Characterization of hc-kit positive cells included immunohistochemical screening with a panel of monoclonal antibodies. Results. Cells, including phase-bright cells identified as hc-kit positive, spontaneously emigrated from hAA-CHF in suspended explant cultures (SEC) after Day 7. When cocultured with tissue, emigrated hc-kit positive cells proliferated, first as loosely attached clones and later as multicellular clusters. At Day 215 of cells were hc-kit positive. Between Days 14 and 28 hc-kit positive cells exhibited mesodermal commitment (GATA- 4 positive and NKX2.5 positive); then after Day 28 cardiac lineages (flk-1 positive, smooth muscle actin positive, troponin-I positive, and myosin light chain positive). Conclusions. C-kit positive hCPCs can be derived from atrial tissue of pediatric patients with end-stage HF. SEC is a novel culture method for derivation of migratory hc-kit positive cells that favors clinical translation by reducing the need for exogenously added factors to expand hCPCs in vitro.