Safety & Efficacy of Intramyocardial Injection of Mesenchymal Precursor Cells on Myocardial Function in LVAD Recipients

Inclusion Criteria:

   - Signed informed consent, inclusive of release of medical information, and Health
   Insurance Portability and Accountability Act (HIPAA) documentation

   - Age 18 years or older

   - If the subject or partner is of childbearing potential, he or she must be willing to
   use adequate contraception (hormonal or barrier method or abstinence) from the time of
   screening and for a period of at least 16 weeks after procedure

   - Female subjects of childbearing potential must have a negative serum pregnancy test at
   screening

   - Admitted to the clinical center at the time of randomization

   - Clinical indication and accepted candidate for implantation of an FDA-approved (US
   sites only) or Health Canada-approved (Canadian sites only) implantable, non-pulsatile
   LVAD as a bridge to transplantation or for destination therapy.

Exclusion Criteria:

   - Planned percutaneous LVAD implantation

   - Anticipated requirement for biventricular mechanical support

   - Concomitant arrhythmia ablation at time of LVAD implantation

   -- Planned aortic valve intervention for aortic insufficiency at the time of LVAD
   implantation

   - Cardiothoracic surgery within 30 days prior to randomization

   - Spontaneous myocardial infarction related to ischemia due to a primary coronary event
   such as unstable plaque rupture, erosion or dissection within 30 days prior to
   randomization

   - Prior cardiac transplantation, LV reduction surgery, or cardiomyoplasty

   - Acute reversible cause of heart failure (e.g. myocarditis, profound hypothyroidism)

   - Stroke within 30 days prior to randomization

   - Platelet count < 100,000/ul within 24 hours prior to randomization

   - Acute infectious process: acute bacterial, fungal, or viral disease OR acute
   exacerbation of chronic infectious disease such as hepatitis

   - Presence of >10% anti-HLA antibody titers with known specificity to MPC donor HLA
   antigens

   - A known hypersensitivity to dimethyl sulfoxide (DMSO), murine, and/or bovine products

   - History of a known active malignancy within the past 3 years except for localized
   prostate cancer, cervical carcinoma in situ, breast cancer in situ, or nonmelanoma
   skin cancer that has been definitively treated

   - Presence of human immunodeficiency virus (HIV)

   - Received investigational intervention within 30 days prior to randomization

   - Treatment and/or an incomplete follow-up treatment of any investigational cell based
   therapy within 6 months prior to randomization

   - Active participation in other research therapy for cardiovascular repair/regeneration

   - Prior recipient of stem precursor cell therapy for cardiac repair

   - Pregnant or breastfeeding at time of randomization.

   - History of known or suspected hypercoagulable state in the opinion of the investigator