3D Bioprinting Technology – One Step Closer Towards Cardiac Tissue Regeneration

For many patients with terminal/advanced cardiac failure, heart transplantation is the most effective, durable treatment option, and offers the best prospects for a high quality of life. The number of potentially life-saving donated human organs is far fewer than the population who could benefit from a new heart, resulting in increasing numbers of patients awaiting replacement of their failing heart, high waitlist mortality, and frequent reliance on interim mechanical support for many of those deemed among the best candidates but who are deteriorating as they wait. Currently, mechanical assist devices supporting left ventricular or biventricular heart function are the only alternative to heart transplant that is in clinical use. Unfortunately, the complication rate with mechanical assistance remains high despite advances in device design and patient selection and management, and the quality of life of the patients even with good outcomes is only moderately improved. Cardiac xenotransplantation from genetically multi-modified (GM) organ-source pigs is an emerging new option as demonstrated by consistent long-term success of heterotopic (non-life-supporting) abdominal and life-supporting orthotopic porcine heart transplantation in baboons, and by a recent ‘compassionate use’ transplant of the heart from a GM pig with 10 modifications into a terminally ill patient who survived for two months. In this review, we discuss pig heart xenotransplantation as a concept, including pathobiological aspects related to immune rejection, coagulation dysregulation, and detrimental overgrowth of the heart, as well as GM strategies in pigs to prevent or minimize these problems. Relevant results of heterotopic and orthotopic heart transplantation experiments in the pig-to-baboon model, microbiological and virologic safety concepts, and efficacy requirements for initiating formal clinical trials are additional topics discussed. An adequate regulatory and ethical framework as well as stringent criteria for the selection of patients will be critical for the safe clinical development of cardiac xenotransplantation, which we expect will be clinically tested during the next few years.

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“…by 3D bioprinting. 21 However, the fabrication of a fully functional heart has yet to be achieved and seems perhaps decades from realization.…”

Section: Introductionmentioning

confidence: 99%

Cardiac xenotransplantation: from concept to clinic

Reichart

Cooper

Längin

et al. 2022

Cardiovascular Research

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“…Advanced methods in cardiac tissue engineering encompass 3D bioprinting, heart-on-a-chip (HoC) technology, and the creation of tissue-engineered cardiac scaffolds. 3D bioprinting allows for the sequential placement of biomaterials to create cardiac constructions that closely resemble the form and function of natural hearts (Bejleri et al, 2018;Wang et al, 2018;Chingale et al, 2022). HoC technology integrates cardiac tissue engineering with microfluidics to replicate human heart physiology and medication reactions in threedimensional models.…”

Section: Advanced Techniques In Cardiac Tissue Engineeringmentioning

confidence: 99%

Advancements in tissue engineering for cardiovascular health: a biomedical engineering perspective

Razavi,

Soltani,

Mahmoudvand

et al. 2024

Front. Bioeng. Biotechnol.

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Myocardial infarction (MI) stands as a prominent contributor to global cardiovascular disease (CVD) mortality rates. Acute MI (AMI) can result in the loss of a large number of cardiomyocytes (CMs), which the adult heart struggles to replenish due to its limited regenerative capacity. Consequently, this deficit in CMs often precipitates severe complications such as heart failure (HF), with whole heart transplantation remaining the sole definitive treatment option, albeit constrained by inherent limitations. In response to these challenges, the integration of bio-functional materials within cardiac tissue engineering has emerged as a groundbreaking approach with significant potential for cardiac tissue replacement. Bioengineering strategies entail fortifying or substituting biological tissues through the orchestrated interplay of cells, engineering methodologies, and innovative materials. Biomaterial scaffolds, crucial in this paradigm, provide the essential microenvironment conducive to the assembly of functional cardiac tissue by encapsulating contracting cells. Indeed, the field of cardiac tissue engineering has witnessed remarkable strides, largely owing to the application of biomaterial scaffolds. However, inherent complexities persist, necessitating further exploration and innovation. This review delves into the pivotal role of biomaterial scaffolds in cardiac tissue engineering, shedding light on their utilization, challenges encountered, and promising avenues for future advancement. By critically examining the current landscape, we aim to catalyze progress toward more effective solutions for cardiac tissue regeneration and ultimately, improved outcomes for patients grappling with cardiovascular ailments.

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“…In the past decades, 3D bioprinting has shown exceptional potential and played an increasingly important role in tissue engineering and organ manufacturing. Currently, there are four major 3D bioprinting modalities, namely extrusionbased bioprinting (EBB), [1][2][3][4] droplet-based bioprinting (DBB), [5][6][7] laser-assisted bioprinting (LAB), [8][9][10] and light-based bioprinting (LBB). [11] Among them, the most commonly used modality is the EBB, [12] in which a print nozzle extrudes a bioink and deposits continuous fibers along a planned path to achieve 3D structures.…”

Section: Introductionmentioning

confidence: 99%

Dissecting the Interplay Mechanism among Process Parameters toward the Biofabrication of High‐Quality Shapes in Embedded Bioprinting

Wu,

Yang,

Gupta

et al. 2024

Adv Funct Materials

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Embedded bioprinting overcomes the barriers associated with the conventional extrusion‐based bioprinting process as it enables the direct deposition of bioinks in 3D inside a support bath by providing in situ self‐support for deposited bioinks during bioprinting to prevent their collapse and deformation. Embedded bioprinting improves the shape quality of bioprinted constructs made up of soft materials and low‐viscosity bioinks, leading to a promising strategy for better anatomical mimicry of tissues or organs. Herein, the interplay mechanism among the printing process parameters toward improved shape quality is critically reviewed. The impact of material properties of the support bath and bioink, printing conditions, cross–linking mechanisms, and post‐printing treatment methods, on the printing fidelity, stability, and resolution of the structures is meticulously dissected and thoroughly discussed. Further, the potential scope and applications of this technology in the fields of bioprinting and regenerative medicine are presented. Finally, outstanding challenges and opportunities of embedded bioprinting as well as its promise for fabricating functional solid organs in the future are discussed.

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3D Bioprinting Technology – One Step Closer Towards Cardiac Tissue Regeneration

Cited by 8 publications

References 166 publications

Cardiac xenotransplantation: from concept to clinic

Cardiac xenotransplantation: from concept to clinic

Advancements in tissue engineering for cardiovascular health: a biomedical engineering perspective

Dissecting the Interplay Mechanism among Process Parameters toward the Biofabrication of High‐Quality Shapes in Embedded Bioprinting

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