Aper Thomas, Wilhelmi Mathias, Gebhardt Christin, Hoeffler Klaus, Benecke Nils, Hilfiker Andres, Haverich Axel
Department of Vascular and Endovascular Surgery, Division for Cardiothoracic-, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Department of Vascular and Endovascular Surgery, Division for Cardiothoracic-, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Acta Biomater. 2016 Jan;29:21-32. doi: 10.1016/j.actbio.2015.10.012. Epub 2015 Oct 21.
The generation of tissue-engineered blood vessel substitutes remains an ongoing challenge for cardiovascular tissue engineering. Full biocompatibility and immediate availability have emerged as central issues for clinical use. To address these issues, we developed a technique that allows the generation of highly stable tubular fibrin segments. The process is based on the compaction of fibrin in a custom-made high-speed rotation mold. In an automated process, fibrin is precipitated from plasma by means of the Vivostat® system. Following application to the rotating mold, the fibrin was compacted by centrifugal force and excess fluid was pressed out. This compaction results in increasing cross-links between the fibrin fibrils and a corresponding significant increase of biomechanical stability up to a burst strength of 230mm of mercury. The molding process allows for a simultaneous seeding procedure. In a first in vivo evaluation in a sheep model, segments of the carotid artery were replaced by tissue-engineered vascular grafts, generated immediately prior to implantation (n=6). Following subjection to the body's remodeling mechanisms, the segments showed a high structural similarity to a native artery after explantation at 6months. Thus, this technique may represent a powerful tool for the generation of biomechanically stable vascular grafts immediately prior to implantation.
Fibrin has previously been shown to be suitable as a matrix for the seeding of different celltypes and for that reason was widely used as scaffold in different fields of tissue engineering. Nevertheless, fibrin's lack of stability has strongly limited its application. Our study describes a novel moulding technique for the generation of a highly compacted fibrin matrix. Using this approach, it was possible to optimize the engineering process of tubular fibrin segments to provide bioartificial vascular grafts within one hour with sufficient stability for immediate implantation in the arterial system. Thus, this technique may represent a powerful tool to get closer to the ultimate aim of an optimal bioartificial vascular graft.
组织工程血管替代物的生成仍然是心血管组织工程领域持续面临的挑战。完全的生物相容性和即时可用性已成为临床应用的核心问题。为解决这些问题,我们开发了一种能够生成高度稳定管状纤维蛋白段的技术。该过程基于在定制的高速旋转模具中对纤维蛋白进行压实。在自动化过程中,通过Vivostat®系统从血浆中沉淀出纤维蛋白。将其应用于旋转模具后,纤维蛋白在离心力作用下被压实,多余的液体被挤出。这种压实导致纤维蛋白原纤维之间的交联增加,生物力学稳定性相应显著提高,直至爆破强度达到230毫米汞柱。成型过程允许同时进行接种程序。在绵羊模型的首次体内评估中,用植入前即刻生成的组织工程血管移植物替换了颈总动脉段(n = 6)。在经历身体的重塑机制后,这些段在6个月后取出时显示出与天然动脉高度相似的结构。因此,该技术可能是在植入前即刻生成生物力学稳定血管移植物的有力工具。
先前已证明纤维蛋白适合作为不同细胞类型接种的基质,因此在组织工程的不同领域中被广泛用作支架。然而,纤维蛋白缺乏稳定性严重限制了其应用。我们的研究描述了一种用于生成高度压实纤维蛋白基质的新型成型技术。使用这种方法,可以优化管状纤维蛋白段的工程过程,在一小时内提供具有足够稳定性的生物人工血管移植物,以便立即植入动脉系统。因此,该技术可能是实现最佳生物人工血管移植物这一最终目标的有力工具。