Experimental and clinical studies have proven the feasibility of cellular cardiomyoplasty in treating the damaged myocardium following ischemic injury. Over the years, this field has exploded with different investigators trying different routes of cell delivery ranging from direct cell injection into the heart to peripheral intravenous delivery utilizing the various signaling mechanisms known. These different routes have resulted in a wide range of retention and engraftment of cells in the target tissues. In this review, we will explore the different modalities of cell delivery, the pros and cons of each route and the cellular retention and therapeutic efficacy of these routes. We will then look into the different theories that try to explain the observed retention and engraftment of cells in the target tissues. Finally, we will discuss various methods that can improve cellular retention and engraftment and hence better improvement in myocardial function.
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