This study aimed to produce an acellular human tissue scaffold with a view to recellularization with autologous cells to produce a tissue-engineered pericardium that can be used as a patch for cardiovascular repair. Human pericardia from cadaveric donors were treated sequentially with hypotonic buffer, SDS in hypotonic buffer, and a nuclease solution. Histological analysis of decellularized matrices showed that the human pericardial tissue retained its histioarchitecture and major structural proteins. There were no whole cells or cell fragments. There were no significant differences in the hydroxyproline (normal and denatured collagen) and glycosaminoglycan content of the tissue before and after decellularization (p > 0.05). There were no significant changes in the ultimate tensile strength after decellularization (p > 0.05). However, there was an increased extensibility when the tissue strips were cut parallel to the visualized collagen bundles (p = 0.005). No indication of contact or extract cytotoxicity was found when using human dermal fibroblasts and A549 cells. In summary, successful decellularization of the human pericardium was achieved producing a biocompatible matrix that retained the major structural components and strength of the native tissue.

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Tissue-engineering approaches to cardiac valve replacement have made considerable advances over recent years and it is likely that this application will realize clinical success in the near future. Research in this area has been driven by the inadequacy of the currently available cardiac valve prostheses for younger patients who require multiple reoperations as they grow and develop. Tissue engineering has the potential to provide a valve capable of the same growth, repair, and regeneration as a natural valve and could improve outcomes for patients of all ages. Owing to the function and physical environment of the cardiac valve, the development of tissue-engineered replacements is unusual in that the biomechanical properties of the construct must dominate the biological properties in order for the valve to be functional at the time of implantation. As a result of this, conventional tissue-engineering scaffolds based on biodegradable polymers or collagen may not at present be suitable in this situation because of their initial limited strength. Research into the use of acellular xenogeneic and allogeneic matrices for tissue-engineered heart valves has consequently become extremely popular since the biomechanical properties of the valve can potentially be preserved with an optimal decellularization technique that removes the cells without damaging the matrix. A number of acellular scaffolds have already been tested clinically both unseeded and preseeded with cells and these have met with variable results. This article reviews the concepts involved and the advantages and disadvantages of the different approaches to tissue engineering a living cardiac valve.

The significantly lower proportion of resolved donors demonstrating a single-hit kinetics response to P. acnes by LDA may represent negative regulation of the CD4+ T-cell response to P. acnes in these subjects.