Decellularized homologous tissue-engineered heart valves as off-the-shelf alternatives to xeno- and homografts

Abstract

Decellularized xenogenic or allogenic heart valves have been used as starter matrix for tissueengineering of valve replacements with (pre-)clinical promising results. However, xenografts are associated with the risk of immunogenic reactions or disease transmission and availability of homografts is limited. Alternatively, biodegradable synthetic materials have been used to successfully create tissue-engineered heart valves (TEHV 178 words

Pulmonary heart valve replacement using stabilized acellular xenogeneic scaffolds; effects of seeding with autologous stem cells

“…At this stage of research, there are numerous aspects which still need to be studied, optimized or tested before HVTE can make an impact on clinical applications. For example, it is not yet known what the ideal scaffold properties are and whether it should be rapidly degradable, slowly degradable or not degradable at all (2,(4)(5)(6)20). Other topics of research are cell sourcing, propagation, whether in vitro differentiation or in vitro mechanical pre-conditioning is needed before implantation, seeding methods, and optimal number of seeded cells.…”

“…This has been recognized as the FDA-recommended animal model for testing new designs of mechanical valves, tissue-based bioprosthetic valves, cryopreserved homografts and biohybrid devices (6,20,(23)(24)(25)(26)(27)(28). Although not initially developed for tissue engineering, sheep implantation continues to be the animal model of choice for testing of acellular valve scaffolds (29)(30)(31)(32)(33)(34).…”

Hemodynamic Characterization of a Mouse Model for Investigating the Cellular and Molecular Mechanisms of Neotissue Formation in Tissue-Engineered Heart Valves

“…Decellularized TEHVs based on biodegradable synthetic materials may serve as suitable replacement of allografts and xenografts, but preclinical study in nonhuman primate and ovine models are characterized by valvular regurgitation due to leaflet shortening and reduced leaflet coaptation. [16][17][18][19] Although decellularized allograft heart valves have been used as TEHV scaffolds with success, 4,5 little is known about the cellular and molecular mechanisms underlying neotissue formation in these TEHVs. To study the mechanisms leading to neotissue formation in decellularized heart valve grafts, we established a mouse model of pulmonary valve transplant 6 and subsequently implanted decellularized mice pulmonary heart valves into isogenic mice recipients.…”

Adipose Derived Tissue Engineered Heart Valve

“…However, the tissue stiffness range is in the right order of magnitude [47,48], which suggests that the TEHVs may perform appropriately in vivo.…”