Abstract
While medicine has made remarkable advances in transplant procedures, there remains a large void of acceptable tissue and organ replacements or substitutes. When autologous tissues are unavailable, synthetic grafts, made out of polytetrafluoroethylene (PTFE or Gore-Tex®) or polyethylene terephthalate (PET or Dacron®), are commonly used. While these nondegradable conduits can be successful in large diameter (>6 mm) operations, they are often susceptible to infection, thrombosis, stenosis, and ectopic calcification. Furthermore, somatic overgrowth is often an issue in the pediatric patient population as these grafts lack growth capacity. Congenital cardiac anomalies are the leading cause of death in the newborn period and affects approximately 1% of all live births. For the nearly one-quarter of congenital heart defect patients that will require major reconstructive surgery, a better alternative is needed.
Tissue engineering is a relatively new scientific field and originally came to the forefront of medicine to address the pervasive shortage of donor tissue and organs. The classic tissue engineering paradigm consists of seeding cells or cellular substitutes on a tissue inducing scaffold. Using this model, the first human TEVG implantation procedure was performed in 1999. Here we take a look at the engineering and biological considerations in vascular medicine and provide background that lead to the current clinical trial investigating the use of tissue-engineered vascular grafts (TEVGs) in congenital heart surgery.
References
Allen RA, Wu W, Yao M, Dutta D, Duan X, Bachman TN, . . . Wang Y (2014). Nerve regeneration and elastin formation within poly(glycerol sebacate)-based synthetic arterial grafts one-year post-implantation in a rat model. Biomaterials 35(1):165–173. https://doi.org/10.1016/j.biomaterials.2013.09.081
Atala A (2009) Engineering organs. Curr Opin Biotechnol 20(5):575–592. https://doi.org/10.1016/j.copbio.2009.10.003
Chemla ES, Morsy M (2009) Randomized clinical trial comparing decellularized bovine ureter with expanded polytetrafluoroethylene for vascular access. Br J Surg 96(1):34–39. https://doi.org/10.1002/bjs.6434
Chlupac J, Filova E, Bacakova L (2009) Blood vessel replacement: 50 years of development and tissue engineering paradigms in vascular surgery. Physiol Res 58(Suppl 2):S119–S139
Cittadella G, de Mel A, Dee R, De Coppi P, Seifalian AM (2013) Arterial tissue regeneration for pediatric applications: inspiration from up-to-date tissue-engineered vascular bypass grafts. Artif Organs 37(5):423–434. https://doi.org/10.1111/aor.12022
Conte MS (1998) The ideal small arterial substitute: a search for the holy grail? FASEB J 12(1):43–45
Darby CR, Roy D, Deardon D, Cornall A (2006) Depopulated bovine ureteric xenograft for complex haemodialysis vascular access. Eur J Vasc Endovasc Surg 31(2):181–186. https://doi.org/10.1016/j.ejvs.2005.07.006
Dong Y, Yong T, Liao S, Chan CK, Stevens MM, Ramakrishna S (2010) Distinctive degradation behaviors of electrospun polyglycolide, poly(DL-lactide-co-glycolide), and poly(L-lactide-co-epsilon-caprolactone) nanofibers cultured with/without porcine smooth muscle cells. Tissue Eng Part A 16(1):283–298. https://doi.org/10.1089/ten.tea.2008.0537
Duncan DR, Breuer CK (2011) Challenges in translating vascular tissue engineering to the pediatric clinic. Vasc Cell 3(1):23. https://doi.org/10.1186/2045-824X-3-23
Fukayama T, Ozai Y, Shimokawadoko H, Aytemiz D, Tanaka R, Machida N, Asakura T (2015) Effect of fibroin sponge coating on in vivo performance of knitted silk small diameter vascular grafts. Organogenesis 11(3):137–151. https://doi.org/10.1080/15476278.2015.1093268
Greisler HP, Kim DU, Price JB, Voorhees AB Jr (1985) Arterial regenerative activity after prosthetic implantation. Arch Surg 120(3):315–323
Harrington JK, Chahboune H, Criscione JM, Li AY, Hibino N, Yi T, … Breuer CK (2011). Determining the fate of seeded cells in venous tissue-engineered vascular grafts using serial MRI. Faseb J 25(12):4150–4161. https://doi.org/10.1096/fj.11-185140
Hashi CK, Zhu Y, Yang GY, Young WL, Hsiao BS, Wang K, … Li S (2007) Antithrombogenic property of bone marrow mesenchymal stem cells in nanofibrous vascular grafts. Proc Natl Acad Sci USA 104(29):11915–11920. https://doi.org/10.1073/pnas.0704581104
Hashi CK, Derugin N, Janairo RR, Lee R, Schultz D, Lotz J, Li S (2010) Antithrombogenic modification of small-diameter microfibrous vascular grafts. Arterioscler Thromb Vasc Biol 30(8):1621–1627. https://doi.org/10.1161/ATVBAHA.110.208348
Hawkins JA, Breinholt JP, Lambert LM, Fuller TC, Profaizer T, McGough EC, Shaddy RE (2000) Class I and class II anti-HLA antibodies after implantation of cryopreserved allograft material in pediatric patients. J Thorac Cardiovasc Surg 119(2):324–330. https://doi.org/10.1016/S0022-5223(00)70188-7
Hibino N, Shin’oka T, Matsumura G, Ikada Y, Kurosawa H (2005) The tissue-engineered vascular graft using bone marrow without culture. J Thorac Cardiovasc Surg 129(5):1064–1070. https://doi.org/10.1016/j.jtcvs.2004.10.030
Hibino N, McGillicuddy E, Matsumura G, Ichihara Y, Naito Y, Breuer C, Shinoka T (2010) Late-term results of tissue-engineered vascular grafts in humans. J Thorac Cardiovasc Surg 139(2):431–436; 436:e431–432. https://doi.org/10.1016/j.jtcvs.2009.09.057
Hibino N, Yi T, Duncan DR, Rathore A, Dean E, Naito Y, … Breuer CK (2011) A critical role for macrophages in neovessel formation and the development of stenosis in tissue-engineered vascular grafts. FASEB J 25(12):4253–4263. https://doi.org/10.1096/fj.11-186585
Kakisis JD, Liapis CD, Breuer C, Sumpio BE (2005) Artificial blood vessel: the holy grail of peripheral vascular surgery. J Vasc Surg 41(2):349–354. https://doi.org/10.1016/j.jvs.2004.12.026
Kasimir MT, Rieder E, Seebacher G, Nigisch A, Dekan B, Wolner E, … Simon P (2006) Decellularization does not eliminate thrombogenicity and inflammatory stimulation in tissue-engineered porcine heart valves. J Heart Valve Dis 15(2): 278–286; discussion 286
Khosravi R, Best CA, Allen RA, Stowell CE, Onwuka E, Zhuang JJ, … Breuer CK (2016) Long-term functional efficacy of a novel electrospun poly(glycerol Sebacate)-based arterial graft in mice. Ann Biomed Eng, 44(8):2402–2416. https://doi.org/10.1007/s10439-015-1545-7
Kim IY, Seo SJ, Moon HS, Yoo MK, Park IY, Kim BC, Cho CS (2008) Chitosan and its derivatives for tissue engineering applications. Biotechnol Adv 26(1):1–21. https://doi.org/10.1016/j.biotechadv.2007.07.009
Klein D, Weisshardt P, Kleff V, Jastrow H, Jakob HG, Ergun S (2011) Vascular wall-resident CD44+ multipotent stem cells give rise to pericytes and smooth muscle cells and contribute to new vessel maturation. PLoS One 6(5):e20540. https://doi.org/10.1371/journal.pone.0020540
Langer R, Vacanti JP (1993) Tissue engineering. Science 260(5110):920–926
L’Heureux N, Dusserre N, Konig G, Victor B, Keire P, Wight TN, … McAllister TN (2006) Human tissue-engineered blood vessels for adult arterial revascularization. Nat Med 12(3):361–365. https://doi.org/10.1038/nm1364
L'Heureux N, McAllister TN, de la Fuente LM (2007) Tissue-engineered blood vessel for adult arterial revascularization. N Engl J Med 357(14):1451–1453. https://doi.org/10.1056/NEJMc071536
Matsumura G, Hibino N, Ikada Y, Kurosawa H, Shin'oka T (2003) Successful application of tissue engineered vascular autografts: clinical experience. Biomaterials 24(13):2303–2308
Mayer JE Jr, Shin’oka T, Shum-Tim D (1997) Tissue engineering of cardiovascular structures. Curr Opin Cardiol 12(6):528–532
McAllister TN, Maruszewski M, Garrido SA, Wystrychowski W, Dusserre N, Marini A, … L’Heureux N (2009) Effectiveness of haemodialysis access with an autologous tissue-engineered vascular graft: a multicentre cohort study. Lancet 373(9673):1440–1446. https://doi.org/10.1016/S0140-6736(09)60248-8
Miller KS, Khosravi R, Breuer CK, Humphrey JD (2015) A hypothesis-driven parametric study of effects of polymeric scaffold properties on tissue engineered neovessel formation. Acta Biomater 11:283–294. https://doi.org/10.1016/j.actbio.2014.09.046
Mo XM, Xu CY, Kotaki M, Ramakrishna S (2004) Electrospun P(LLA-CL) nanofiber: a biomimetic extracellular matrix for smooth muscle cell and endothelial cell proliferation. Biomaterials 25(10):1883–1890
Muto A, Fitzgerald TN, Pimiento JM, Maloney SP, Teso D, Paszkowiak JJ, … Dardik A (2007) Smooth muscle cell signal transduction: implications of vascular biology for vascular surgeons. . J Vasc Surg 45 (Suppl A):A15–A24. https://doi.org/10.1016/j.jvs.2007.02.061
Naito Y, Shinoka T, Duncan D, Hibino N, Solomon D, Cleary M, … Breuer C (2011) Vascular tissue engineering: towards the next generation vascular grafts. Adv Drug Deliv Rev 63(4–5):312–323. https://doi.org/10.1016/j.addr.2011.03.001
Naito Y, Rocco K, Kurobe H, Maxfield M, Breuer C, Shinoka T (2014) Tissue engineering in the vasculature. Anat Rec (Hoboken) 297(1):83–97. https://doi.org/10.1002/ar.22838
Noishiki Y, Tomizawa Y, Yamane Y, Matsumoto A (1996) Autocrine angiogenic vascular prosthesis with bone marrow transplantation. Nat Med 2(1):90–93
Pachence JM, Kohn J (2000) Biodegradable Polymers. In: Langer R, Lanza RT, Vacanti JP (eds) Principles of tissue engineering. Academic Press, San Diego, pp 263–277
Pankajakshan D, Agrawal DK (2010) Scaffolds in tissue engineering of blood vessels. Can J Physiol Pharmacol 88(9):855–873. https://doi.org/10.1139/y10-073
Patlolla A, Collins G, Arinzeh TL (2010) Solvent-dependent properties of electrospun fibrous composites for bone tissue regeneration. Acta Biomater 6(1):90–101. https://doi.org/10.1016/j.actbio.2009.07.028
Patterson JT, Gilliland T, Maxfield MW, Church S, Naito Y, Shinoka T, Breuer CK (2012) Tissue-engineered vascular grafts for use in the treatment of congenital heart disease: from the bench to the clinic and back again. Regen Med 7(3):409–419. https://doi.org/10.2217/rme.12.12
Pektok E, Nottelet B, Tille JC, Gurny R, Kalangos A, Moeller M, Walpoth BH (2008) Degradation and healing characteristics of small-diameter poly(epsilon-caprolactone) vascular grafts in the rat systemic arterial circulation. Circulation 118(24):2563–2570. https://doi.org/10.1161/CIRCULATIONAHA.108.795732
Peppas NA, Langer R (1994) New challenges in biomaterials. Science 263(5154):1715–1720
Rocco KA, Maxfield MW, Best CA, Dean EW, Breuer CK (2014) In vivo applications of electrospun tissue-engineered vascular grafts: a review. Tissue Eng Part B Rev 20(6):628–640. https://doi.org/10.1089/ten.TEB.2014.0123
Rockwood DN, Preda RC, Yucel T, Wang X, Lovett ML, Kaplan DL (2011) Materials fabrication from Bombyx mori silk fibroin. Nat Protoc 6(10):1612–1631. https://doi.org/10.1038/nprot.2011.379
Roh JD, Nelson GN, Brennan MP, Mirensky TL, Yi T, Hazlett TF, … Breuer CK (2008) Small-diameter biodegradable scaffolds for functional vascular tissue engineering in the mouse model. Biomaterials 29(10):1454–1463. https://doi.org/10.1016/j.biomaterials.2007.11.041
Roh JD, Sawh-Martinez R, Brennan MP, Jay SM, Devine L, Rao DA, … Breuer CK (2010) Tissue-engineered vascular grafts transform into mature blood vessels via an inflammation-mediated process of vascular remodeling. Proc Natl Acad Sci USA 107(10):4669–4674. https://doi.org/10.1073/pnas.0911465107
Rosso F, Marino G, Giordano A, Barbarisi M, Parmeggiani D, Barbarisi A (2005) Smart materials as scaffolds for tissue engineering. J Cell Physiol 203(3):465–470. https://doi.org/10.1002/jcp.20270
Shin’oka T, Imai Y, Ikada Y (2001) Transplantation of a tissue-engineered pulmonary artery. N Engl J Med 344(7):532–533. https://doi.org/10.1056/NEJM200102153440717
Shin’oka T, Matsumura G, Hibino N, Naito Y, Watanabe M, Konuma T, … Kurosawa H (2005) Midterm clinical result of tissue-engineered vascular autografts seeded with autologous bone marrow cells. J Thorac Cardiovasc Surg 129(6):1330–1338. https://doi.org/10.1016/j.jtcvs.2004.12.047
Soffer L, Wang X, Zhang X, Kluge J, Dorfmann L, Kaplan DL, Leisk G (2008) Silk-based electrospun tubular scaffolds for tissue-engineered vascular grafts. J Biomater Sci Polym Ed 19(5):653–664. https://doi.org/10.1163/156856208784089607
Su Y, Li X, Liu Y, Su Q, Qiang ML, Mo X (2011) Encapsulation and controlled release of heparin from electrospun poly(L-Lactide-co-epsilon-Caprolactone) nanofibers. J Biomater Sci Polym Ed 22(1–3):165–177. https://doi.org/10.1163/092050609X12583785588757
Sugiura T, Matsumura G, Miyamoto S, Miyachi H, Breuer CK, Shinoka T (2018) Tissue-engineered vascular grafts in children with congenital heart Disease: Intermediate Term Follow-up. Semin Thorac Cardiovasc Surg. https://doi.org/10.1053/j.semtcvs.2018.02.002
Tara S, Kurobe H, Rocco KA, Maxfield MW, Best CA, Yi T, … Shinoka T (2014a) Well-organized neointima of large-pore poly(L-lactic acid) vascular graft coated with poly(L-lactic-co-epsilon-caprolactone) prevents calcific deposition compared to small-pore electrospun poly(L-lactic acid) graft in a mouse aortic implantation model. Atherosclerosis 237(2):684–691. https://doi.org/10.1016/j.atherosclerosis.2014.09.030
Tara S, Rocco KA, Hibino N, Sugiura T, Kurobe H, Breuer CK, Shinoka T (2014b) Vessel Bioengineering. Circ J:12–19. https://doi.org/10.1253/circj.CJ-13-1440
Ulery BD, Nair LS, Laurencin CT (2011) Biomedical applications of biodegradable polymers. J Polym Sci B Polym Phys 49(12):832–864. https://doi.org/10.1002/polb.22259
Vacanti JP, Langer R (1999) Tissue engineering: the design and fabrication of living replacement devices for surgical reconstruction and transplantation. Lancet 354(Suppl 1):SI32–SI34
van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, Roos-Hesselink JW (2011) Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 58(21):2241–2247. https://doi.org/10.1016/j.jacc.2011.08.025
Wang Y, Ameer GA, Sheppard BJ, Langer R (2002) A tough biodegradable elastomer. Nat Biotechnol 20(6):602–606. https://doi.org/10.1038/nbt0602-602
Wang S, Mo XM, Jiang BJ, Gao CJ, Wang HS, Zhuang YG, Qiu LJ (2013) Fabrication of small-diameter vascular scaffolds by heparin-bonded P(LLA-CL) composite nanofibers to improve graft patency. Int J Nanomedicine 8:2131–2139. https://doi.org/10.2147/IJN.S44956
Watanabe M, Shin’oka T, Tohyama S, Hibino N, Konuma T, Matsumura G, … Morita S (2001) Tissue-engineered vascular autograft: inferior vena cava replacement in a dog model. Tissue Eng 7(4):429–439. https://doi.org/10.1089/10763270152436481
Woodruff MA, Hutmacher DW (2010) The return of a forgotten polymer-Polycaprolactone in the 21st century. Prog Polym Sci 35(10):1217–1256. https://doi.org/10.1016/j.progpolymsci.2010.04.002
Wu H, Fan J, Chu CC, Wu J (2010) Electrospinning of small diameter 3-D nanofibrous tubular scaffolds with controllable nanofiber orientations for vascular grafts. J Mater Sci Mater Med 21(12):3207–3215. https://doi.org/10.1007/s10856-010-4164-8
Xu C, Inai R, Kotaki M, Ramakrishna S (2004) Electrospun nanofiber fabrication as synthetic extracellular matrix and its potential for vascular tissue engineering. Tissue Eng 10(7–8):1160–1168. https://doi.org/10.1089/ten.2004.10.1160
Xue L, Greisler HP (2003) Biomaterials in the development and future of vascular grafts. J Vasc Surg 37(2):472–480. https://doi.org/10.1067/mva.2003.88
Zhang M, Li XH, Gong YD, Zhao NM, Zhang XF (2002) Properties and biocompatibility of chitosan films modified by blending with PEG. Biomaterials 23(13):2641–2648
Zilla P, Bezuidenhout D, Human P (2007) Prosthetic vascular grafts: wrong models, wrong questions and no healing. Biomaterials 28(34):5009–5027. https://doi.org/10.1016/j.biomaterials.2007.07.017
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Shoji, T., Breuer, C., Shinoka, T. (2020). Tissue-Engineered Vascular Grafts for Children. In: Walpoth, B., Bergmeister, H., Bowlin, G., Kong, D., Rotmans, J., Zilla, P. (eds) Tissue-Engineered Vascular Grafts. Reference Series in Biomedical Engineering(). Springer, Cham. https://doi.org/10.1007/978-3-319-71530-8_19-1
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