Document Detail


Clinical application of tissue engineered human heart valves using autologous progenitor cells.
MedLine Citation:
PMID:  16820562     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tissue engineering (TE) of heart valves reseeded with autologous cells has been successfully performed in vitro. Here, we report our first clinical implantation of pulmonary heart valves (PV) engineered with autologous endothelial progenitor cells (EPCs) and the results of 3.5 years of follow-up. METHODS AND RESULTS: Human PV allografts were decellularized (Trypsin/EDTA) and resulting scaffolds reseeded with peripheral mononuclear cells isolated from human blood. Positive stain for von Willebrand factor, CD31, and Flk-1 was observed in monolayers of cells cultivated and differentiated on the luminal surface of the scaffolds in a dynamic bioreactor system for up to 21 days, indicating endothelial nature. PV reseeded with autologous cells were implanted into 2 pediatric patients (age 13 and 11) with congenital PV failure. Postoperatively, a mild pulmonary regurgitation was documented in both children. Based on regular echocardiographic investigations, hemodynamic parameters and cardiac morphology changed in 3.5 years as follows: increase of the PV annulus diameter (18 to 22.5 mm and 22 to 26 mm, respectively), decrease of valve regurgitation (trivial/mild and trivial, respectively), decrease (16 to 9 mm Hg) or a increase (8 to 9.5 mm Hg) of mean transvalvular gradient, remained 26 mm or decreased (32 to 28 mm) right-ventricular end-diastolic diameter. The body surface area increased (1.07 to 1.42 m2 and 1.07 to 1.46 m2, respectively). No signs of valve degeneration were observed in both patients. CONCLUSIONS: TE of human heart valves using autologous EPC is a feasible and safe method for pulmonary valve replacement. TE valves have the potential to remodel and grow accordingly to the somatic growth of the child.
Authors:
Serghei Cebotari; Artur Lichtenberg; Igor Tudorache; Andres Hilfiker; Heike Mertsching; Rainer Leyh; Thomas Breymann; Klaus Kallenbach; Liviu Maniuc; Aurel Batrinac; Oleg Repin; Oxana Maliga; Anatol Ciubotaru; Axel Haverich
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  114     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-05     Completed Date:  2006-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  I132-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany. cebotari.serghei@mh-hannover.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Bioprosthesis*
Bioreactors
Cell Differentiation
Cells, Cultured / cytology,  transplantation
Child
Feasibility Studies
Female
Follow-Up Studies
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation*
Humans
Male
Monocytes / cytology,  transplantation*
Postoperative Complications / etiology,  surgery
Pulmonary Artery / abnormalities
Pulmonary Valve / abnormalities,  surgery*
Pulmonary Valve Insufficiency / etiology,  surgery*
Tetralogy of Fallot / surgery
Tissue Engineering* / instrumentation,  methods
Transplantation, Autologous
Transplantation, Homologous
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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