June 29, 2011 – For the first time, human blood vessels grown in a laboratory from donor skin cells have been successfully implanted into patients, according to new research presented in the American Heart Association (AHA)’s Emerging Science Series webinar.
While more testing is needed, such “off-the-shelf” blood vessels could soon be used to improve the process and affordability of kidney dialysis.
The grafts also have the potential to be used in lower limb bypass to route blood around diseased arteries, to repair congenital heart defects in pediatric patients and to fix damaged arteries in soldiers who might otherwise lose a limb.
The tissue-engineered blood vessels, produced from sheets of cultured skin cells rolled around temporary support structures, were used to create access shunts between arteries and veins in the arm for kidney dialysis in three patients. These shunts, which connect an artery to a vein, provide access to the blood for dialysis. The engineered vessels were about a foot long with a diameter of 4.8 millimeters.
At follow-up exams up to eight months after implantation, none of the patients had developed an immune reaction to the implants, and the vessels withstood the high pressure and frequent needle punctures required for dialysis. Shunts created from patients’ own vessels or synthetic materials are notoriously prone to failure.
Investigators previously showed that using vessels individually created from a patient’s own skin cells reduced the rate of shunt complications 2.4-fold over a 3-year period. The availability of off-the-shelf vessels could avoid the expense and months-long process involved in creating custom vessels for each patient, making the technique feasible for widespread use.
Besides addressing a costly and vexing problem in kidney dialysis, off-the-shelf blood vessels might someday be used instead of harvesting patients’ own vessels for bypass surgery. A larger, randomized trial of the grafts is under way for kidney dialysis, and human trials have been initiated to assess the safety and effectiveness of these grafts for lower-limb bypass.
Co-authors are Wojciech Wystrychowski, M.D.; Lech Cierpka, M.D.; Krzysztof Zagalski, M.D.; Sergio A. Garrido, M.D.; Samuel Radochonski, B.S.; Nathalie Dusserre, Ph.D.; and Nicholas L’Heureux, Ph.D.
Author disclosures are on the abstract. Cytograft funded the study.
For more information: www.newsroom.heart.org