title: Chest wall repair with engineered fetal bone grafts: an efficacy analysis in an autologous leporine model.
abstract: OBJECTIVE
  We sought to compare the efficacy of engineered fetal bone grafts with acellular constructs in an autologous model of chest wall repair.
  
  
  METHODS
  Rabbits (n = 10) with a full-thickness sternal defect were equally divided in 2 groups based on how the defect was repaired, namely, either with an autologous bone construct engineered with amniotic mesenchymal stem cells on a nanofibrous scaffold or a size-matched identical scaffold with no cells. Animals were killed at comparable time-points 18 to 20 weeks postimplantation for multiple analyses.
  
  
  RESULTS
  Gross evidence of nonunion confirmed by micro-computed tomography scanning was present in 3 (60%) of 5 of the acellular implants but in no engineered grafts. Histology confirmed the presence of bone in both types of repair, albeit seemingly less robust in the acellular grafts. Mineral density in vivo was significantly higher in engineered grafts than in acellular ones, with more variability among the latter. There was no difference in alkaline phosphatase activity between the groups.
  
  
  CONCLUSIONS
  Chest wall repair with an autologous osseous graft engineered with amniotic mesenchymal stem cells leads to improved and more consistent outcomes in the midterm when compared with an equivalent acellular prosthetic repair in a leporine model. Amniotic fluid-derived engineered bone may become a practical alternative for perinatal chest wall reconstruction.
authors.affiliation: Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Justin D
authors.initials: JD
authors.lastname: Klein
authors.forename: Christopher G B
authors.initials: CG
authors.lastname: Turner
authors.forename: Azra
authors.initials: A
authors.lastname: Ahmed
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Steigman
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.forename: Dario O
authors.initials: DO
authors.lastname: Fauza
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D006085:Graft Survival; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D011817:Rabbits; D013249:Sternum / Q000166:cytology / Q000196:embryology* / Q000637:transplantation; D013896:Thoracic Diseases / Q000151:congenital / Q000601:surgery*; D035441:Thoracic Wall / Q000002:abnormalities* / Q000601:surgery; D023822:Tissue Engineering / Q000379:methods*; D014182:Transplantation, Autologous