Extracellular matrix for reconstruction of cardiac structures after tumour resections

Decellularization is the process of removing the cellular components from tissues or organs. It is a promising technology for obtaining a biomaterial with a highly preserved extracellular matrix (ECM), which may also act as a biological scaffold for tissue engineering and regenerative therapies. Decellularized products are gaining clinical importance and market space due to their ease of standardized production, constant availability for grafting and mechanical or biochemical superiority against competing clinical options, yielding clinical results ahead of the ones with autografts in some applications. Current drawbacks and limitations of traditional treatments and clinical applications can be overcome by using decellularized or acellular matrices. Several companies are leading the market with versatile acellular products designed for diverse use in the reconstruction of tissues and organs. This review describes ECM-based decellularized and acellular products that are currently in use for different branches of clinic.

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“…E.g. extensive left atrial myxoma, right atrial leiomyosarcoma or treatment of right atrial metastasis of malignant melanoma [140].…”

Section: Cardiac Patchmentioning

confidence: 99%

Clinical applications of decellularized extracellular matrices for tissue engineering and regenerative medicine

et al. 2016

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“…Another important aspect is the antigenicity induced by the donor tissue. One approach to solve this issue is to use hetero- or xenogeneic tissues further processed to acellular scaffolds [ 3 – 8 ]. Acellular scaffolds have reduced antigenicity [ 9 ] and provide a matrix exclusively consisting of extracellular matrix (ECM), which likely facilitates the processes of healing and biointegration [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Acellularization-Induced Changes in Tensile Properties Are Organ Specific - An In-Vitro Mechanical and Structural Analysis of Porcine Soft Tissues

Schleifenbaum¹,

Prietzel²,

Aust

et al. 2016

PLoS ONE

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IntroductionThough xenogeneic acellular scaffolds are frequently used for surgical reconstruction, knowledge of their mechanical properties is lacking. This study compared the mechanical, histological and ultrastructural properties of various native and acellular specimens.Materials and MethodsPorcine esophagi, ureters and skin were tested mechanically in a native or acellular condition, focusing on the elastic modulus, ultimate tensile stress and maximum strain. The testing protocol for soft tissues was standardized, including the adaption of the tissue’s water content and partial plastination to minimize material slippage as well as templates for normed sample dimensions and precise cross-section measurements. The native and acellular tissues were compared at the microscopic and ultrastructural level with a focus on type I collagens.ResultsIncreased elastic modulus and ultimate tensile stress values were quantified in acellular esophagi and ureters compared to the native condition. In contrast, these values were strongly decreased in the skin after acellularization. Acellularization-related decreases in maximum strain were found in all tissues. Type I collagens were well-preserved in these samples; however, clotting and a loss of cross-linking type I collagens was observed ultrastructurally. Elastins and fibronectins were preserved in the esophagi and ureters. A loss of the epidermal layer and decreased fibronectin content was present in the skin.DiscussionAcellularization induces changes in the tensile properties of soft tissues. Some of these changes appear to be organ specific. Loss of cross-linking type I collagen may indicate increased mechanical strength due to decreasing transverse forces acting upon the scaffolds, whereas fibronectin loss may be related to decreased load-bearing capacity. Potentially, the alterations in tissue mechanics are linked to organ function and to the interplay of cells and the extracellular matrix, which is different in hollow organs when compared to skin.

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“…The first case report describing the successful use of CorMatrix ECM 1 patch for reconstruction of the free right atrial wall and superior vena cava following resection of a large leiomyosarcoma was published by Szczeklik et al 28 Recently, a small case series has been published by our group describing a successful reconstruction of cardiac structures with SIS-ECM patches following tumor resections (huge left atrial myxoma, right atrial leiomyosarcoma right atrial metastasis of malignant melanoma). 29 This report demonstrates the acellular xenogeneic SIS-ECM membrane (CorMatrix ECM 1 , CorMatrix Cardiovascular, Inc.) as an excellent alternative material to synthetic or biological (pericardial) substitute materials to treat various cardiac defects. Compared to conventional pericardial patches, the advantage of this material is excellent pliability and easy handling, therefore less risk of tearing of myocardium/tissue as well as very easy stitching by thin composition of the material.…”

Section: Postmyocardial Infarction Ventricular Repairmentioning

confidence: 88%

“…The first case report describing the successful use of CorMatrix ECM ® patch for reconstruction of the free right atrial wall and superior vena cava following resection of a large leiomyosarcoma was published by Szczeklik et al Recently, a small case series has been published by our group describing a successful reconstruction of cardiac structures with SIS‐ECM patches following tumor resections (huge left atrial myxoma, right atrial leiomyosarcoma right atrial metastasis of malignant melanoma) …”

Section: Characteristics (Advantages and Disadvantages) Of Different mentioning

confidence: 99%

The Use of Extracellular Matrix Patches in Cardiac Surgery

et al. 2014

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Extracellular matrix for reconstruction of cardiac structures after tumour resections

Abstract: Extracellular matrix patches are a potential alternative for pericardial patches for complex reconstructions of atrial structures because of their pliable characteristics and consecutively reduced need for haemostatic stitches.

Cited by 5 publications

References 13 publications

Clinical applications of decellularized extracellular matrices for tissue engineering and regenerative medicine

Clinical applications of decellularized extracellular matrices for tissue engineering and regenerative medicine

Acellularization-Induced Changes in Tensile Properties Are Organ Specific - An In-Vitro Mechanical and Structural Analysis of Porcine Soft Tissues

The Use of Extracellular Matrix Patches in Cardiac Surgery

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