Vascular tissue engineering: building perfusable vasculature for implantation

Abstract

Tissue and organ replacement is required when there are no alternative therapies available. Although vascular tissue engineering was originally developed to meet the clinical demands of small-diameter vascular conduits as bypass grafts, it has evolved into a highly advanced field where perfusable vasculatures are generated for implantation. Herein, we review several cutting-edge techniques that have led to implantable human blood vessels in clinical trials, the novel approaches that build complex perfusable microvascular networks in functional tissues, the use of stem cells to generate endothelial cells for vascularization, as well as the challenges in bringing vascular tissue engineering technologies into the clinics.

Development and characterization of an ex vivo arterial long-term proliferation model for restenosis research

“…In the past, decellularized blood vessels have been studied for their potential use as vascular grafts for small diameter arteries (Antonova et al, 2008;Borschel et al, 2005;Jo et al, 2007;Schaner et al, 2004;Gui and Niklason, 2014). They consist of a natural extracellular matrix, have very low immunogenicity and can be reseeded with various cells of choice and for any period of time (Teebken et al, 2009;Amiel et al, 2006).…”

The Heart and Great Vessels

“…The feasibility of such grafts for hemodialysis access has been established as the implanted Lifeline grafts (Cytograft Tissue Engineering, Novato, CA) in three patients showed vascular integrity over an 11-month course without signs of immunogenic responses (McAllister et al 2009; Wystrychowski et al 2014). In fact, multicenter trials are underway to evaluate the safety and efficacy of Cytograft and Humacyte graft use in this respect (Gui and Niklason 2014). Because our inability to replicate arterial biomechanical properties, aneurysmal dilation of the graft and rupture are complications associated with conduits placed in high-pressure systems (Mirensky et al 2009).…”

Human adipose-derived stromal cells for the production of completely autologous self-assembled tissue-engineered vascular substitutes

“…Many tissue-engineered vascular substitutes (TEVS) have been developed in recent years but excessively long production time, poor mechanical resistance, thrombogenicity and immunogenicity are some of the drawbacks preventing their clinical use [3][4][5][6]. Among strategies for vascular reconstruction reviewed elsewhere [3][4][5][6], the engineering of entirely autologous vessel by the self-assembly approach has been first achieved by our group [7].…”

“…Among strategies for vascular reconstruction reviewed elsewhere [3][4][5][6], the engineering of entirely autologous vessel by the self-assembly approach has been first achieved by our group [7]. These tissue-engineered blood vessels made from dermal fibroblasts (DF), vascular smooth muscle cells (SMC) and endothelial cells (EC) comprised the three layers naturally present in native arteries, namely the adventitia, media and intima [7].…”