Mesenchymal stem cells (MSCs) transplantation has been proposed as a promising means for the repair and regeneration of heart cells in ischemia heart disease. However, advancement in stem cell therapy is hindered by the poor survival of implanted cells. Recently, many kinds of methods have been developed to prevent stem cells apoptosis and improve their therapeutic potential in the ischemia heart, including genetically modifying, retaining viability in vitro, suitable transplantation means, and preconditioning. Despite the great promise of these methods, there are still many problems to be solved in this field, including limited kinds of experimental animals, few clinical trials, and cell differentiation. (C) 2008 Elsevier Inc. All rights reserved.