Wharton’s Jelly–Mesenchymal Stem Cell–Engineered Conduit for Pulmonary Artery Reconstruction in Growing Piglets

In Vivo Imaging of Tissue-Engineered Grafts Within Pulmonary Artery of a Growing Large Animal Model

“…The presence of these bioactive molecules allows exogenous and endogenous cellularization of SIS, which is important for host integration. In this study, Rapetto et al 2 demonstrate the use of allogenic WJ-MSCs as an effective cell source to reconstruct the MPA. Wharton’s jelly is the mucous proteoglycan-rich matrix surrounding the vessels within the umbilical cord and has been identified as a region with a large, unique cell population of MSCs.…”

“…In this issue of JACC: Basic to Translational Science , Rapetto et al 2 use porcine small intestinal submucosa (SIS) grafts with and without seeding of allogeneic mesenchymal stem cells derived from Wharton’s jelly (WJ-MSCs) for reconstruction of the MPA in a growing swine model. 2 The beating hearts of 4-week-old piglets in this model were accessed via median sternotomy followed by the excision of an 8-mm segment of the MPA and replacement with the tissue-engineered SIS interposition grafts. All 11 animals that underwent surgery survived, although 2 animals died before the first follow-up, which the investigators attribute to causes unrelated to the graft implantation.…”

“…Assessment of tissue-engineered reconstructions in growing animal models is a long-standing challenge in vascular graft research. Rapetto et al 2 used transthoracic echocardiography and cardiac magnetic resonance imaging to follow the in vivo progression of their pulmonary artery replacement graft in a growing porcine model. The porcine model of pulmonary artery replacement in a piglet weighing about 20 kg included the excision of 8 mm of native pulmonary artery while the animal was on cardiopulmonary bypass, as previously established.…”

Current development of bovine jugular vein conduit for right ventricular outflow tract reconstruction

“…Compared with the characterization apparatuses, bioreactors hold even greater potentials. Ditkowski et al and Leeten et al used bioreactors to model BJVC behaviours - bacterial adherence and endothelialization, respectively ( Ditkowski et al, 2019 ; Leeten et al, 2021 ), whereas many other researchers attempted to achieve cell repopulation of decellularized conduits with bioreactors ( Teebken et al, 2003 ; Lichtenberg et al, 2006 ; Yuan et al, 2016 ; Iacobazzi et al, 2021 ; Rapetto et al, 2022 ). Although the development of an ideal bioreactor and a standard conduit-engineering protocol is still in it is infancy, a decellularized BJVC repopulated with autologous cells offering a close-to-autograft operation choice may well be where the future lies ( Cleuziou, 2018 ).…”

Growth capacity of a Wharton’s Jelly derived mesenchymal stromal cells tissue engineered vascular graft used for main pulmonary artery reconstruction in piglets

“…We have recently developed a TE vascular graft consisting of a Wharton's Jelly derived mesenchymal stromal cells (WJ-MSC) seeded onto a Small Intestinal Submucosa (SIS), and tested it in a porcine model of main pulmonary artery (MPA) reconstruction as a first safety study. This preliminary investigation showed the safety, tissue remodelling and integration capacity of our TE product (named WJ-MSC SIS) within the host, as compared to the acellular scaffold (Rapetto et al, 2022). In this study we aim at testing the growing capacity and efficacy of our WJ-MSC-seeded SIS product by performing a full-scale pre-clinical study of MPA reconstruction in growing piglet (Figure 1).…”