PMID- 15373223
OWN - NLM
STAT- MEDLINE
DCOM- 20041106
LR  - 20110726
IS  - 0301-4894 (Print)
IS  - 0301-4894 (Linking)
VI  - 105
IP  - 8
DP  - 2004 Aug
TI  - [Clinical results of tissue-engineered vascular autografts seeded with autologous 
      bone marrow cells].
PG  - 459-63
AB  - In May 2000 we initiated clinical application of tissue-engineered (TE) vascular 
      grafts seeded with cultured cells. However, cell culturing is time-consuming and 
      xeno-serum must be used. To overcome these disadvantages, we started to use bone 
      marrow cells (BMCs), readily available on the day of surgery, as a cell source. 
      The aim of this study was to assess the safety and feasibility of this technique 
      for creating pulmonary arteries. METHODS: Since August 2000, TE grafts seeded 
      with autologous BMCs have been implanted in 42 patients. Bone marrow (5 ml/kg) 
      was aspirated under general anesthesia prior to the skin incision. The polymer 
      tube serving as a scaffold for the cells was composed of a co-polymer of 
      1-lactide and epsilon-caprolactone (50:50). This co-polymer is degraded by 
      hydrolysis. The matrix is >80% porous and the diameter of each pore is 100-200 
      microm. Polyglycolic acid woven fabric with a thickness of 0.5 mm was used for 
      reinforcement. Twenty-three TE conduits (TCPC grafts) and 19 TE patches were used 
      for the repair of congenital heart defects. The patients' ages ranged from 1 to 
      24 years (median, 5.5 years). All patients underwent a catheterization study 
      and/or computed tomography (CT) scans for evaluation after surgery. The patients 
      received anticoagulation therapy for 3 to 6 months after surgery. RESULTS: Mean 
      follow-up after surgery was 584 days (maximum 42 months). There were no lethal 
      complications such as thrombosis or aneurysmal rupture. One late death at 3 
      months after TCPC was noted in a hypoplastic left heart syndrome patient, which 
      was unrelated to the TE graft. There was no evidence of aneurysm formation on 
      cineangiography or CT. CONCLUSIONS: Biodegradable conduits or pulmonary vessel 
      patches seeded with autologous BMCs showed normal function (good patency up to 
      maximum follow-up of 38 months). As living tissues, these vessels may have the 
      potential for growth, repair, and remodeling. The TE approach may provide an 
      important alternative to the use of prosthetic materials in the field of 
      pediatric cardiovascular surgery. Longer follow-up is necessary to confirm the 
      feasibility of this approach.
FAU - Shin'oka, Toshiharu
AU  - Shin'oka T
AD  - Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's 
      Medical University, Tokyo, Japan.
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Nihon Geka Gakkai Zasshi
JT  - Nihon Geka Gakkai zasshi
JID - 0405405
SB  - IM
MH  - Animals
MH  - Bone Marrow Transplantation/*methods
MH  - Dogs
MH  - Humans
MH  - Pulmonary Artery/cytology/*surgery
MH  - Sheep
MH  - Tissue Engineering/*methods
EDAT- 2004/09/18 05:00
MHDA- 2004/11/09 09:00
CRDT- 2004/09/18 05:00
PHST- 2004/09/18 05:00 [pubmed]
PHST- 2004/11/09 09:00 [medline]
PHST- 2004/09/18 05:00 [entrez]
PST - ppublish
SO  - Nihon Geka Gakkai Zasshi. 2004 Aug;105(8):459-63.