The Evolution of Vascular Tissue Engineering and Current State of the Art Cells Tissues Organs

Review

doi: x.1159/000331406. Epub 2011 Oct thirteen.

The evolution of vascular tissue engineering and current state of the art

Affiliations

PMID: 21996786
PMCID: PMC3325604
DOI: 10.1159/000331406

Free PMC article

Review

The development of vascular tissue engineering science and electric current land of the fine art

Marissa Peck et al. Cells Tissues Organs. 2012 .

Free PMC article

Abstract

Dacron® (polyethylene terephthalate) and Goretex® (expanded polytetrafluoroethylene) vascular grafts accept been very successful in replacing obstructed blood vessels of large and medium diameters. All the same, every bit diameters decrease below 6 mm, these grafts are clearly outperformed by transposed autologous veins and, particularly, arteries. With approximately viii meg individuals with peripheral arterial affliction, over 500,000 patients diagnosed with finish-phase renal disease, and over 250,000 patients per year undergoing coronary bypass in the USA alone, at that place is a critical clinical need for a functional small-bore conduit [Lloyd-Jones et al., Apportionment 2010;121:e46-e215]. Over the concluding decade, we have witnessed a dramatic prototype shift in cardiovascular tissue technology that has driven the field abroad from biomaterial-focused approaches and towards more biology-driven strategies. In this article, nosotros review the preclinical and clinical efforts in the quest for a tissue-engineered blood vessel that is free of permanent synthetic scaffolds but has the mechanical force to become a successful arterial graft. Special emphasis is given to the tissue engineering by cocky-assembly (TESA) approach, which has been the only 1 to achieve clinical trials for applications under arterial pressure.

Figures

**Fig. 1**
a The workhorse of TESA: a sheet of HSFs. The sheets tin can become very robust depending on the culture time and weather. b Sheet holding 500 g.

Fig. 2 — **Fig. two**
a An historic period- and risk-matched homo TEBV for implantation in the aorta of nude rats (ID one.5 mm). b After 180 days in a nude rat, Verhoff-Masson staining reveals a collagen-rich (blue) and acellular IM as well too-adult elastic lamellas in the 'neo-media' on the luminal side of the IM. The arrow indicates vasa vasorum in the 'adventitia'. Scale bar = 20 μm. c SMC-specific α-actin staining of the vessel afterwards 90 days confirms that the cells in the 'neo-media' are SMC-like cells. The arrow indicates cells around the IM that are positive, suggesting a phenotypic transformation of the implanted fibroblasts or a recruitment of cells from the surrounding tissue. Comparison of the thickness of the 'neo-media' in b and c shows that it does not thicken with fourth dimension. Scale bar = 100 μm. d At the anastomotic region at 90 days, Movat staining shows a smoothen interface (large arrow) and the divergence in elastin (black) between the native aorta and the remodeling graft. Pocket-size arrows betoken sutures. Calibration bar = 500 μm.

**Fig. 3**
Before beginning the clinical trials, nosotros tested the resistance of the man grafts punctured in vitro nether physiological pressure level (**a–c**) versus an ePTFE graft (**d–f**). While both grafts seal well one time the needle is inserted (a, d), the ePTFE graft leaks aggressively later on removal of the 16-gauge hemodialysis needle while our graft self-seals like a native vessel. Note the poor compliance of the ePTFE around the needle in d. Leaking grafts are clinically difficult to manage because they require pressure to stop the haemorrhage, which can likewise cause graft thrombosis.

**Fig. 4**
Evolution of our tissue-engineered graft. We have followed a strategy that initially favors a positive clinical outcome over ease of production. But when some level of clinical success is demonstrated do nosotros introduce toll-effective design changes. If early results are confirmed in follow-up studies, we could produce an allogeneic, serum-gratuitous, off-the-shelf, and completely biological graft in about ten weeks by using TBTE.

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The Evolution of Vascular Tissue Engineering and Current State of the Art Cells Tissues Organs