Human iliac vein replacement with a tissue-engineered graft.
The modification of a previously described technique to generate venous conduits in a lamb model from a decellularised matrix and autologous cells and its application to human tissue is described. A 49-year-old woman underwent surgery for a large malignant pelvic tumour (carcinoma of unknown primary) involving the right iliac artery and vein. The right iliac artery was reconstructed with a cryopreserved human arterial allograft. For iliac vein reconstruction a tissue-engineered neo-vein was developed utilising a decellularised cryopreserved vein allograft that was reseeded in a bioreactor with autologous endothelial cells derived from the recipient's great saphenous vein. Both interposition grafts were patent initially, after 3, 6, 12, and 24 months, but the tissue-engineered neo-vein had become obstructed due to evolving disease four month postoperatively. Tissue engineered neo-veins may be a therapeutic option in selected cases with symptomatic vein stenosis or obstruction not curable with interventional methods or standard prosthetic replacement.
Teebken
O E
OE
Hannover Medical School, Dept. of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover, Germany.
Puschmann
C
C
Rohde
B
B
Burgwitz
K
K
Winkler
M
M
Pichlmaier
A M
AM
Weidemann
J
J
Haverich
A
A
D000925:Anticoagulants / Q000627:therapeutic use; D001705:Bioprosthesis; D019149:Bioreactors; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D018929:Cell Culture Techniques; D015925:Cryopreservation; D042783:Endothelial Cells / Q000637:transplantation; D005260:Female; D005263:Femoral Artery / Q000637:transplantation; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000601:surgery; D007084:Iliac Vein / Q000473:pathology / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010386:Pelvic Neoplasms / Q000473:pathology / Q000601:surgery*; D012501:Saphenous Vein / Q000637:transplantation; D013997:Time Factors; D023822:Tissue Engineering; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000637:transplantation
D000925:Anticoagulants