European Homograft Bank (EHB), EHB, Méridien Site, Rue du Méridien 100, 1210, Brussels, Belgium.
Cell Tissue Bank. 2021 Dec;22(4):519-537. doi: 10.1007/s10561-021-09902-2. Epub 2021 Feb 2.
For over 30 years, our TE has processed, controlled for quality and distributed cryopreserved allograft valves for human application. We present a review of this activity and future perspectives of cardiovascular tissue banking. The donor age and medical/behavioral history are in compliance with the regulations of the EUMS. Allograft morphology and function are evaluated in a class A cleanroom. Tests for viral/bacterial infection, histological control of structure/infection/malignancy and control-rate cryopreservation are performed. A total of 7562 hearts were sent to our TE, whereas 7290 valves (pulmonary, aortic and mitral) were transplanted. The donations increased over time: 1934, 2566 and 3062 hearts were donated during the first, second and third decades (increases of 32.7 and 19.3% during the second and third decades). Likewise, there was a significant increase in transplantations with 2050, 2550 and 2690 valves implanted during the first, second and third decades (24.4 and 5.5% increase during the second and third decades). A total of 4475 pulmonary (61.4%), 2760 aortic (37.9%) and 55 mitral valves (0.7%) were transplanted. Outstanding long-term results in adults and evidence of immune-related deterioration of allografts in neonates and infants were demonstrated. Decellularization was suggested as a solution. One hundred pulmonary and 180 aortic valves were sent for transplantation after decellularization for the ESPOIR and ARISE clinical trials and beyond. The donation and transplantation activity increased progressively. Although cryopreserved valves represent the best substitute for diseased valves, accelerated failure appears after implantation in neonates and infants. The implementation of new technologies, such as decellularization, as a standard procedure for treatment of allograft valves will offer further improvements in allograft quality and increase of durability.
三十多年来，我们的 TE 一直负责处理、质量控制和分发可低温保存的同种异体瓣膜用于人体应用。我们对这项活动进行了回顾，并对心血管组织库的未来前景进行了展望。供体年龄和医疗/行为史均符合欧盟 MS 的规定。同种异体瓣膜的形态和功能在 A 级洁净室进行评估。进行病毒/细菌感染检测、结构/感染/恶性肿瘤的组织学控制以及控速冷冻保存。共有 7562 颗心脏被送到我们的 TE，其中 7290 个瓣膜（肺动脉瓣、主动脉瓣和二尖瓣）被移植。随着时间的推移，捐赠数量不断增加：在第一个、第二个和第三个十年中，分别有 1934、2566 和 3062 颗心脏被捐赠（第二个和第三个十年分别增加了 32.7%和 19.3%）。同样，移植数量也显著增加，在第一个、第二个和第三个十年中，分别有 2050、2550 和 2690 个瓣膜被植入（第二个和第三个十年分别增加了 24.4%和 5.5%）。总共移植了 4475 个肺动脉瓣（61.4%）、2760 个主动脉瓣（37.9%）和 55 个二尖瓣（0.7%）。在成人中取得了优异的长期结果，并证明了同种异体移植物在新生儿和婴儿中免疫相关恶化的证据。去细胞化被认为是一种解决方案。在 ESPOIR 和 ARISE 临床试验以及之后，100 个肺动脉瓣和 180 个主动脉瓣被送去进行去细胞化移植。捐赠和移植活动逐渐增加。虽然低温保存的瓣膜是病变瓣膜的最佳替代品，但在新生儿和婴儿中植入后，瓣膜的失效速度似乎加快了。为了提高同种异体瓣膜的质量和耐用性，需要实施新的技术，如去细胞化，并将其作为同种异体瓣膜治疗的标准程序。
