Tissue Engineering Program and Surgical Research, Nationwide Children's Hospital, Columbus, Ohio.
Pediatric Surgery, Tissue Engineering Program and Surgical Research, Nationwide Children's Hospital, Columbus, Ohio.
Transl Res. 2014 Apr;163(4):321-41. doi: 10.1016/j.trsl.2014.01.014. Epub 2014 Jan 30.
A fundamental problem that affects the field of cardiovascular surgery is the paucity of autologous tissue available for surgical reconstructive procedures. Although the best results are obtained when an individual's own tissues are used for surgical repair, this is often not possible as a result of pathology of autologous tissues or lack of a compatible replacement source from the body. The use of prosthetics is a popular solution to overcome shortage of autologous tissue, but implantation of these devices comes with an array of additional problems and complications related to biocompatibility. Transplantation offers another option that is widely used but complicated by problems related to rejection and donor organ scarcity. The field of tissue engineering represents a promising new option for replacement surgical procedures. Throughout the years, intensive interdisciplinary, translational research into cardiovascular regenerative implants has been undertaken in an effort to improve surgical outcome and better quality of life for patients with cardiovascular defects. Vascular, valvular, and heart tissue repair are the focus of these efforts. Implants for these neotissues can be divided into 2 groups: biologic and synthetic. These materials are used to facilitate the delivery of cells or drugs to diseased, damaged, or absent tissue. Furthermore, they can function as a tissue-forming device used to enhance the body's own repair mechanisms. Various preclinical studies and clinical trials using these advances have shown that tissue-engineered materials are a viable option for surgical repair, but require refinement if they are going to reach their clinical potential. With the growth and accomplishments this field has already achieved, meeting those goals in the future should be attainable.
一个影响心血管外科学领域的基本问题是用于手术重建的自体组织的缺乏。虽然当使用个体自身的组织用于手术修复时可获得最佳结果，但由于自体组织的病变或缺乏来自身体的相容替代来源，这通常是不可能的。使用假体是克服自体组织短缺的一种流行解决方案，但这些装置的植入会带来一系列与生物相容性相关的其他问题和并发症。移植提供了另一种广泛使用的选择，但与排斥和供体器官稀缺相关的问题使该选择变得复杂。组织工程领域代表了替代手术程序的一个有前途的新选择。多年来，人们一直在进行心血管再生植入物的密集跨学科转化研究，以努力改善手术结果并提高心血管缺陷患者的生活质量。血管、瓣膜和心脏组织修复是这些努力的重点。用于这些新生组织的植入物可分为 2 组：生物和合成。这些材料用于将细胞或药物递送到患病、受损或缺失的组织。此外，它们可以作为组织形成装置用于增强身体自身的修复机制。使用这些进展进行的各种临床前研究和临床试验表明，组织工程材料是手术修复的一种可行选择，但如果要发挥其临床潜力，则需要进一步改进。随着该领域已经取得的增长和成就，未来实现这些目标应该是可行的。
