Toward a patient-specific tissue engineered vascular graft

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Abstract

Integrating three-dimensional printing with the creation of tissue-engineered vascular grafts could provide a readily available, patient-specific, autologous tissue source that could significantly improve outcomes in newborns with congenital heart disease. Here, we present the recent case of a candidate for our tissue-engineered vascular graft clinical trial deemed ineligible due to complex anatomical requirements and consider the application of three-dimensional printing technologies for a patient-specific graft. We 3D-printed a closed-disposable seeding device and validated that it performed equivalently to the traditional open seeding technique using ovine bone marrow–derived mononuclear cells. Next, our candidate’s preoperative imaging was reviewed to propose a patient-specific graft. A seeding apparatus was then designed to accommodate the custom graft and 3D-printed on a commodity fused deposition modeler. This exploratory feasibility study represents an important proof of concept advancing progress toward a rationally designed patient-specific tissue-engineered vascular graft for clinical application.

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The incidence of congenital heart disease.

Julien Hoffman, Samuel Kaplan (2002)

This study was designed to determine the reasons for the variability of the incidence of congenital heart disease (CHD), estimate its true value and provide data about the incidence of specific major forms of CHD. The incidence of CHD in different studies varies from about 4/1,000 to 50/1,000 live births. The relative frequency of different major forms of CHD also differs greatly from study to study. In addition, another 20/1,000 live births have bicuspid aortic valves, isolated anomalous lobar pulmonary veins or a silent patent ductus arteriosus. The incidences reported in 62 studies published after 1955 were examined. Attention was paid to the ways in which the studies were conducted, with special reference to the increased use of echocardiography in the neonatal nursery. The total incidence of CHD was related to the relative frequency of ventricular septal defects (VSDs), the most common type of CHD. The incidences of individual major forms of CHD were determined from 44 studies. The incidence of CHD depends primarily on the number of small VSDs included in the series, and this number in turn depends upon how early the diagnosis is made. If major forms of CHD are stratified into trivial, moderate and severe categories, the variation in incidence depends mainly on the number of trivial lesions included. The incidence of moderate and severe forms of CHD is about 6/1,000 live births (19/1,000 live births if the potentially serious bicuspid aortic valve is included), and of all forms increases to 75/1,000 live births if tiny muscular VSDs present at birth and other trivial lesions are included. Given the causes of variation, there is no evidence for differences in incidence in different countries or times.

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Tissue-engineered vascular grafts transform into mature blood vessels via an inflammation-mediated process of vascular remodeling.

Brooks Udelsman, W. Saltzman, Tamar L Mirensky … (2010)

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are the earliest tissue-engineered vascular grafts (TEVGs) to be used clinically. These TEVGs transform into living blood vessels in vivo, with an endothelial cell (EC) lining invested by smooth muscle cells (SMCs); however, the process by which this occurs is unclear. To test if the seeded BMCs differentiate into the mature vascular cells of the neovessel, we implanted an immunodeficient mouse recipient with human BMC (hBMC)-seeded scaffolds. As in humans, TEVGs implanted in a mouse host as venous interposition grafts gradually transformed into living blood vessels over a 6-month time course. Seeded hBMCs, however, were no longer detectable within a few days of implantation. Instead, scaffolds were initially repopulated by mouse monocytes and subsequently repopulated by mouse SMCs and ECs. Seeded BMCs secreted significant amounts of monocyte chemoattractant protein-1 and increased early monocyte recruitment. These findings suggest TEVGs transform into functional neovessels via an inflammatory process of vascular remodeling.

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Emerging Biofabrication Strategies for Engineering Complex Tissue Constructs.

R Daniel Pedde, Bahram Mirani, Ali Navaei … (2017)

The demand for organ transplantation and repair, coupled with a shortage of available donors, poses an urgent clinical need for the development of innovative treatment strategies for long-term repair and regeneration of injured or diseased tissues and organs. Bioengineering organs, by growing patient-derived cells in biomaterial scaffolds in the presence of pertinent physicochemical signals, provides a promising solution to meet this demand. However, recapitulating the structural and cytoarchitectural complexities of native tissues in vitro remains a significant challenge to be addressed. Through tremendous efforts over the past decade, several innovative biofabrication strategies have been developed to overcome these challenges. This review highlights recent work on emerging three-dimensional bioprinting and textile techniques, compares the advantages and shortcomings of these approaches, outlines the use of common biomaterials and advanced hybrid scaffolds, and describes several design considerations including the structural, physical, biological, and economical parameters that are crucial for the fabrication of functional, complex, engineered tissues. Finally, the applications of these biofabrication strategies in neural, skin, connective, and muscle tissue engineering are explored.

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Author and article information

Journal

Journal ID (nlm-ta): J Tissue Eng

Journal ID (iso-abbrev): J Tissue Eng

Journal ID (publisher-id): TEJ

Journal ID (hwp): sptej

Title: Journal of Tissue Engineering

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Electronic): 2041-7314

Publication date (Electronic): 16 March 2018

Publication date Collection: Jan-Dec 2018

Volume: 9

Electronic Location Identifier: 2041731418764709

Affiliations

[1 ]Center for Regenerative Medicine, The Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

[2 ]Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, OH, USA

[3 ]Research Innovation and Solutions, The Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

[4 ]Department of Cardiology, The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA

[5 ]Department of Surgery, Nationwide Children’s Hospital, Columbus, OH, USA

[6 ]Advanced Cardiac Imaging Laboratory, The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA

[7 ]Department of Cardiothoracic Surgery, The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA

Author notes

[*]Cameron Best, Center for Regenerative Medicine, The Research Institute, Nationwide Children’s Hospital, 575 Children’s Crossroad—WB4154, Columbus, OH 43215, USA. Email: Cameron.Best@ 123456nationwidechildrens.org

Article

Publisher ID: 10.1177_2041731418764709

DOI: 10.1177/2041731418764709

PMC ID: 5858675

PubMed ID: 29568478

SO-VID: 7125f001-11f8-42fa-8582-42dde15dd13e

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 27 November 2017

Date accepted : 20 February 2018

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cover-date January-December 2018

ScienceOpen disciplines: Biomedical engineering

Keywords: tissue-engineered vascular graft,3d-printing,fontan operation,patient-specific modeling,cell seeding

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ScienceOpen disciplines: Biomedical engineering

Keywords: tissue-engineered vascular graft, 3d-printing, fontan operation, patient-specific modeling, cell seeding

Toward a patient-specific tissue engineered vascular graft

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Abstract

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Journal of Disability Research

Most cited references 35

The incidence of congenital heart disease.

Tissue-engineered vascular grafts transform into mature blood vessels via an inflammation-mediated process of vascular remodeling.

Emerging Biofabrication Strategies for Engineering Complex Tissue Constructs.

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