Successful tissue engineering of competent allogeneic venous valves

• Published in: Journal of vascular surgery 2015-10, Vol.3 (4), p.421-430.e1
• Main Authors: Kuna, Vijay Kumar, MSc, Rosales, Antonio, MD, Hisdal, Jonny, PhD, Osnes, Eivind K., MD, PhD, Sundhagen, Jon O., MD, Bäckdahl, Henrik, PhD, Sumitran-Holgersson, Suchitra, PhD, Jørgensen, Jørgen J., MD, PhD
• Format: Article
• Language: English
• Subjects: adult; allograft; biochemical analysis; Cardiac and Cardiovascular Systems; controlled study; cytology; decellularization; DNA; endothelium cell; Femoral Vein; human; human cell; human tissue; Humans; immunohistochemistry; in vitro study; Kardiologi; mitral valve; recellularization; scleroprotein; smooth muscle fiber; Surgery; Tissue Engineering; Tissue Scaffolds; vein compliance; vein valve; Venous Insufficiency - therapy; Venous Pressure; Venous Valves
• ISSN: 2213-333X; 0741-5214; 2213-3348
• DOI: 10.1016/j.jvsv.2014.12.002

Objective The purpose of this study was to evaluate whether tissue-engineered human allogeneic vein valves have a normal closure time (competency) and tolerate reflux pressure in vitro. Methods Fifteen human allogeneic femoral vein segments containing valves were harvested from cadavers. Valve closure time and resistance to reflux pressure (100 mm Hg) were assessed in an in vitro model to verify competency of the vein valves. The segments were tissue engineered using the technology of decellularization (DC) and recellularization (RC). The decellularized and recellularized vein segments were characterized biochemically, immunohistochemically, and biomechanically. Results Four of 15 veins with valves were found to be incompetent immediately after harvest. In total, 2 of 4 segments with incompetent valves and 10 of 11 segments with competent valves were further decellularized using detergents and DNAse. DC resulted in significant decrease in host DNA compared with controls. DC scaffolds, however, retained major extracellular matrix proteins and mechanical integrity. RC resulted in successful repopulation of the lumen and valves of the scaffold with endothelial and smooth muscle cells. Valve mechanical parameters were similar to the native tissue even after DC. Eight of 10 veins with competent valves remained competent even after DC and RC, whereas the two incompetent valves remained incompetent even after DC and RC. The valve closure time to reflux pressure of the tissue-engineered veins was