Early obstruction of decellularized xenogenic valves in pediatric patients: involvement of inflammatory and fibroproliferative processes

Cicha, Iwona; Rüffer, André; Cesnjevar, Robert; Glöckler, Martin; Agaimy, Abbas; Daniel, Werner G.; Garlichs, Christoph D.; Dittrich, Sven

doi:10.1016/j.carpath.2010.04.006

Cited by 65 publications

(57 citation statements)

References 31 publications

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“…Currently available acellular xenogeneic pulmonary heart valve scaffolds have shown clinical outcomes [17][18][19][20] that have indicated the need for the development of acellular valved conduits that are devoid of cells, DNA and residual a-gal. To the authors' knowledge, this is the first study that has assessed the total DNA and the presence of a-gal in all regions (leaflets, pulmonary wall, myocardium, and leaflet connection) of an acellular porcine pulmonary root conduit.…”

Section: Figmentioning

confidence: 99%

“…17,19 It was also reported that the Matrix PÔ Plus valve displayed early obstruction following implantation in pediatric patients. 20 It is likely that these problems were due to the glutaraldehyde fixed pericardial patches used in the grafts. 20 The latest version of the valve, the Matrix P Plus N, has been decribed as a cell-free valve incorporating a cell free unfixed pericardial patch.…”

mentioning

confidence: 99%

“…20 It is likely that these problems were due to the glutaraldehyde fixed pericardial patches used in the grafts. 20 The latest version of the valve, the Matrix P Plus N, has been decribed as a cell-free valve incorporating a cell free unfixed pericardial patch.…”

mentioning

confidence: 99%

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Development and Characterization of Acellular Porcine Pulmonary Valve Scaffolds for Tissue Engineering

Luo

Korossis

Wilshaw

et al. 2014

Tissue Engineering Part A

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Currently available replacement heart valves all have limitations. This study aimed to produce and characterize an acellular, biocompatible porcine pulmonary root conduit for reconstruction of the right ventricular outflow tract e.g., during Ross procedure. A process for the decellularization of porcine pulmonary roots was developed incorporating trypsin treatment of the adventitial surface of the scraped pulmonary artery and sequential treatment with hypotonic Tris buffer (HTB; 10 mM Tris pH 8.0, 0.1% (w/v) EDTA, and 10 KIU aprotinin), 0.1% (w/v) sodium dodecyl sulfate in HTB, two cycles of DNase and RNase, and sterilization with 0.1% (v/v) peracetic acid. Histology confirmed an absence of cells and retention of the gross histoarchitecture. Immunohistochemistry further confirmed cell removal and partial retention of the extracellular matrix, but a loss of collagen type IV. DNA levels were reduced by more than 96% throughout all regions of the acellular tissue and no functional genes were detected using polymerase chain reaction. Total collagen levels were retained but there was a significant loss of glycosaminoglycans following decellularization. The biomechanical, hydrodynamic, and leaflet kinematics properties were minimally affected by the process. Both immunohistochemical labeling and antibody absorption assay confirmed a lack of a-gal epitopes in the acellular porcine pulmonary roots and in vitro biocompatibility studies indicated that acellular leaflets and pulmonary arteries were not cytotoxic. Overall the acellular porcine pulmonary roots have excellent potential for development of a tissue substitute for right ventricular outflow tract reconstruction e.g., during the Ross procedure.

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Section: Figmentioning

confidence: 99%

mentioning

confidence: 99%

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Development and Characterization of Acellular Porcine Pulmonary Valve Scaffolds for Tissue Engineering

Luo

Korossis

Wilshaw

et al. 2014

Tissue Engineering Part A

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“…12 Theoretically, these conditions could be fulfilled by employing tissue decellularization techniques to produce viable, antigen-free, and hemodynamically stable tissueengineered scaffolds that would support recolonization with native cells and thus perform equivalently to other tissue-engineered valves.…”

Section: Discussionmentioning

confidence: 99%

“…11 The attempt to produce a nonimmunogenic substitute, undistinguishable from a native valve regarding mechanical strength, growth, and remodeling, has led to the introduction of various decellularized homograft or xenograft valve conduits in which the immunogenic cellular elements of the tissue have been removed. 12 Enzymatic removal of cells and cellular remnants significantly reduces immunologic reaction, 13 whereas the intact ECM scaffold is expected to improve recolonization of decellularized conduits with native cells, as experimental evidence exists that the decellularized matrix becomes populated with functional native cells. [14][15][16] To our knowledge, this is the first study to analyze 3 different methods of heart valve tissue decellularization using collagenase enzyme.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Abdolghafoorian

Farnia²,

Rs³

et al. 2017

Exp Clin Transplant

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Objectives: Endothelial cells harbor many antigenic determinants that may be targets for the immune system. The aim of this study was to determine the immunologic effects of decellularization, using 3 different methods, on xenograft rejection. Materials and Methods: In a sterile plate containing phosphate-buffered saline, fresh sheep aortic heart valves were decellularized using 3 different enzymatic methods: with 900 µg/mL of collagenase at 40°C (method A), with 450 µg/mL of collagenase at 4°C (method B), and with 900 µg/mL of collagenase at 4°C (method C). Intact and decellularized valves were implanted subdermally into inbred male albino rabbits and extracted after 21 days (extra valve pieces were also extracted after 60 days, as control samples, for assessing chronic rejection). Valves were histologically analyzed for inflammatory cell infiltration. Subendothelial structure integrity was determined using surface electron microscope. Results: No inflammatory cell infiltration was seen around the decellularized valve with method A, and no subendothelial structure change was observed by surface electron microscope. Infiltration of immune cells involved in rejection was not seen around valves decellularized with method B, although the subendothelial structure was relatively preserved and valve stiffness was increased. With method C, we observed a foreign body-type reaction around the intact valve and the decellularized valve. Conclusions: Method A is considered the optimal method of decellularization in our study, as this method significantly reduced the immune response to xenograft tissue, while maintaining subendothelial tissue.

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Developing a Clinically Relevant Tissue Engineered Heart Valve—A Review of Current Approaches

Nachlas

Davis

2017

Adv Healthcare Materials

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Tissue engineered heart valves (TEHVs) have the potential to address the shortcomings of current implants through the combination of cells and bioactive biomaterials that promote growth and proper mechanical function in physiological conditions. The ideal TEHV should be anti-thrombogenic, biocompatible, durable, and resistant to calcification, and should exhibit a physiological hemodynamic profile. In addition, TEHVs may possess the capability to integrate and grow with somatic growth, eliminating the need for multiple surgeries children must undergo. Thus, this review assesses clinically available heart valve prostheses, outlines the design criteria for developing a heart valve, and evaluates three types of biomaterials (decellularized, natural, and synthetic) for tissue engineering heart valves. While significant progress has been made in biomaterials and fabrication techniques, a viable tissue engineered heart valve has yet to be translated into a clinical product. Thus, current strategies and future perspectives are also discussed to facilitate the development of new approaches and considerations for heart valve tissue engineering.

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Early obstruction of decellularized xenogenic valves in pediatric patients: involvement of inflammatory and fibroproliferative processes

Cited by 65 publications

References 31 publications

Development and Characterization of Acellular Porcine Pulmonary Valve Scaffolds for Tissue Engineering

Development and Characterization of Acellular Porcine Pulmonary Valve Scaffolds for Tissue Engineering

Untitled

Developing a Clinically Relevant Tissue Engineered Heart Valve—A Review of Current Approaches

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