Table 1.
Advantages and drawbacks of different types of stem cells, delivery methods and fabricated biomaterials used.
Stem cell type | Advantages | Drawbacks | Ref. |
---|---|---|---|
Embryonic | Clonality, self-renewal, pluripotency |
Ethical concern |
[3,10,12,32] |
Very sensitive to temperature and pH changes |
|||
Bone marrow derived adult stem cells |
No ethical issues; widely investigated under pre-clinical and clinical settings |
Access requires invasive surgery |
[139] |
Isolation is required due to heterogeneous cell population |
|||
Adipose derived adult stem cells |
Less invasive and painful surgery |
Isolation is required due to heterogeneous cell population |
[3,19,139] |
Induced pluripotent | Alternative to embryonic cells |
Probability of forming teratoma |
[5,25] |
Availability of producing large amounts of patient-specific cells |
|||
Endothelial progenitor | Production of large amounts of growth factors and cytokines |
Rare population | [31,140] |
Delivery methods | Advantages | Drawbacks | Ref. |
Intracoronary | No risk of systemic delivery |
Low cell delivery | [35] |
Direct delivery | |||
Intravenous | Not invasive | Cells can be isolated in lung, liver or spleen |
[36,38,141] |
Intramyocardial | Direct delivery | Perforation risk | [43] |
Intrapericardial | Large number of cells delivered |
Visceral pericardium transmigration required |
[40] |
Retrograde coronary sinus | Homogeneous cell delivery | Endothelial wall transmigration required |
[48] |
Biomaterials | Advantages | Possible concerns | Ref. |
Cell sheets | Long-term survival and growth rate after implementation |
Retention of implant at transplant site; integration to host tissue |
[79,81] |
Injectable hydrogels | Enhance stem cell retention and survivability upon injection |
Suitable rheological properties of the injected materials |
[142] |
Porous scaffolds | Increased Vascularization | Biodegradation properties | [92] |