title: Coating with fibronectin and stromal cell-derived factor-1α of decellularized homografts used for right ventricular outflow tract reconstruction eliminates immune response-related degeneration.
abstract: OBJECTIVE
  This study assesses the performance and cellular features of decellularized ovine aortic homografts coated with stromal cell-derived factor-1α (SDF-1α) and its natural linker, fibronectin (FN), after implantation in the right ventricular outflow tract of adolescent sheep.
  
  
  METHODS
  Right ventricular outflow tract reconstructions using cryopreserved (n = 7), decellularized (n = 8), and decellularized FN/SDF-1α-coated aortic ovine homografts (n = 6) were performed. Echocardiographic, morphologic, radiographic, histologic, and immunohistochemical examinations were performed 5 months after implantation.
  
  
  RESULTS
  There were no hemodynamic differences between groups, except for the decellularized homografts' tendency to develop more valve regurgitation (3 of 8 grafts had regurgitation >2/4). All decellularized, but coated, grafts had normal hemodynamics. Decellularized valve conduits were less calcified than cryopreserved conduits (P < .05), but coated valve conduits were free of calcification (P < .05). The same was found for pannus in the outflow parts. Immune response (CD45(+), CD45R(+), or CD11b(+) cells) was decreased in decellularized valves compared with cryopreserved grafts, but was virtually absent (P < .05) in coated grafts. Collagen organization and density in the leaflets and walls were decreased in cryopreserved and decellularized valves, but not in coated valves (P < .05). Coating improved re-endothelialization (P < .05).
  
  
  CONCLUSIONS
  Coating of decellularized allografts with FN/SDF-1α prevents cryopreserved heart valve-mediated immune response, conduit calcification, and pannus formation and stimulates re-endothelialization.
authors.affiliation: Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium. Electronic address: willem.flameng@med.kuleuven.be.
authors.forename: Willem
authors.initials: W
authors.lastname: Flameng
authors.affiliation: Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.
authors.forename: Geofrey
authors.initials: G
authors.lastname: De Visscher
authors.affiliation: Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Mesure
authors.affiliation: Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.
authors.forename: Hadewich
authors.initials: H
authors.lastname: Hermans
authors.affiliation: European Homograft Bank, Brussels, Belgium.
authors.forename: Ramadan
authors.initials: R
authors.lastname: Jashari
authors.affiliation: Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Meuris
mesh_terms: D064591:Allografts; D000818:Animals; D001021:Aortic Valve / Q000637:transplantation*; D001705:Bioprosthesis; D054377:Chemokine CXCL12 / Q000008:administration & dosage*; D015925:Cryopreservation; D005353:Fibronectins / Q000008:administration & dosage*; D006352:Heart Ventricles / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000276:immunology / Q000517:prevention & control; D011474:Prosthesis Design; D012756:Sheep
chemical_list: D054377:Chemokine CXCL12; D005353:Fibronectins