Decellularized human valve allografts
Decellularized human valve allografts
复制标题
DOI：
10.1016/s0003-4975(01)02503-6
复制
发表时间：
2001-05-01
影响因子：
4.6
通讯作者：
Black, KS
中科院分区：
文献类型：
--
作者：
Elkins, RC;Dawson, PE;Black, KS
背景儿童和一些成人同种异体移植组织的不同表现可能与免疫反应有关，可以通过降低植入物抗原性来减轻。由于内皮细胞和成纤维细胞可能是瓣膜抗原性的来源，因此使用Synergraft处理过程对人（CryoValve SG）和绵羊肺动脉瓣进行脱细胞处理。采用组织化学、生物力学和流体动力学方法对经处理的瓣膜进行体外评价，并与标准冷冻保存瓣膜进行比较。在生长期绵羊的右心室流出道中植入4个经Synergraft处理的和2个冷冻保存的绵羊肺动脉瓣作为根部置换，并在3个月和6个月时进行超声心动图和组织学监测。36例患者植入CryoValve SG人工肺动脉瓣。SynerGraft处理降低了组织抗原表达，但未改变人瓣膜生物力学或强度。脱细胞绵羊同种异体瓣膜在植入期间是功能性的，并且，它们逐渐与受体细胞再细胞化。在人体中，CryoValve SG肺动脉瓣未引起群体反应性抗体应答。SynerGraft脱细胞使瓣膜的物理性质保持不变，并大大减少抗原含量。植入物细胞结构的减少使得基质的宿主再细胞化成为可能，这将有利地影响长期移植物耐久性。(C)2001年由胸外科医师协会出版。
Background. Variable performance of allograft tissues in children and some adults may be linked to an immune response and could be mitigated by reducing implant antigenicity.Methods. As endothelial and fibroblast cells are the likely source of valve antigenicity, human (CryoValve SG) and sheep pulmonary valves were decellularized using the SynerGraft treatment process. Treated valves were evaluated in vitro using histochemical, biomechanical, and hydrodynamic methods, and compared with standard cryopreserved valves. Four SynerGraft-treated and two cryopreserved sheep pulmonary valves were implanted as root replacements in the right ventricular outflow tract of growing sheep and monitored echocardiographically and histologically at 3 and 6 months. CryoValve SG human pulmonary valves were implanted in 36 patients.Results. SynerGraft treatment reduced tissue antigen expression but did not alter human valve biomechanics or strength. Decellularized sheep allograft valves were functional during the implantation period, and, they became progressively recellularized with recipient cells. In humans, CryoValve SG pulmonary valves did not provoke a panel reactive antibody response.Conclusions. SynerGraft decellularization leaves the physical properties of valves unaltered and substantially diminishes antigen content. Reduction in implant cellularity enables host recellularization of the matrix, which should favorably impact long-term graft durability. (C) 2001 by The Society of Thoracic Surgeons.