title: Decellularized homologous tissue-engineered heart valves as off-the-shelf alternatives to xeno- and homografts.
abstract: Decellularized xenogenic or allogenic heart valves have been used as starter matrix for tissue-engineering of valve replacements with (pre-)clinical promising results. However, xenografts are associated with the risk of immunogenic reactions or disease transmission and availability of homografts is limited. Alternatively, biodegradable synthetic materials have been used to successfully create tissue-engineered heart valves (TEHV). However, such TEHV are associated with substantial technological and logistical complexity and have not yet entered clinical use. Here, decellularized TEHV, based on biodegradable synthetic materials and homologous cells, are introduced as an alternative starter matrix for guided tissue regeneration. Decellularization of TEHV did not alter the collagen structure or tissue strength and favored valve performance when compared to their cell-populated counterparts. Storage of the decellularized TEHV up to 18 months did not alter valve tissue properties. Reseeding the decellularized valves with mesenchymal stem cells was demonstrated feasible with minimal damage to the reseeded valve when trans-apical valve delivery was simulated. In conclusion, decellularization of in-vitro grown TEHV provides largely available off-the-shelf homologous scaffolds suitable for reseeding with autologous cells and trans-apical valve delivery.
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, GEM-Z 4.110, PO Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: Petra E
authors.initials: PE
authors.lastname: Dijkman
authors.forename: Anita
authors.initials: A
authors.lastname: Driessen-Mol
authors.forename: Laura
authors.initials: L
authors.lastname: Frese
authors.forename: Simon P
authors.initials: SP
authors.lastname: Hoerstrup
authors.forename: Frank P T
authors.initials: FP
authors.lastname: Baaijens
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D002454:Cell Differentiation / Q000502:physiology; D002470:Cell Survival / Q000502:physiology; D002478:Cells, Cultured; D005109:Extracellular Matrix / Q000378:metabolism; D006351:Heart Valves / Q000166:cytology* / Q000648:ultrastructure; D059630:Mesenchymal Stem Cells / Q000166:cytology / Q000648:ultrastructure; D008855:Microscopy, Electron, Scanning; D012756:Sheep; D023822:Tissue Engineering / Q000379:methods*