Toward a patient-specific tissue engineered vascular graft

Abstract

Integrating three-dimensional printing with the creation of tissue-engineered vascular grafts could provide a readily available, patient-specific, autologous tissue source that could significantly improve outcomes in newborns with congenital heart disease. Here, we present the recent case of a candidate for our tissue-engineered vascular graft clinical trial deemed ineligible due to complex anatomical requirements and consider the application of three-dimensional printing technologies for a patient-specific graft. We 3D-printed a closed-disposable seeding device and validated that it performed equivalently to the traditional open seeding technique using ovine bone marrow–derived mononuclear cells. Next, our candidate’s preoperative imaging was reviewed to propose a patient-specific graft. A seeding apparatus was then designed to accommodate the custom graft and 3D-printed on a commodity fused deposition modeler. This exploratory feasibility study represents an important proof of concept advancing progress toward a rationally designed patient-specific tissue-engineered vascular graft for clinical application.

Aortic “Disease-in-a-Dish”: Mechanistic Insights and Drug Development Using iPSC-Based Disease Modeling

“…The use of TEVGs in regenerative medicine is still under development, with many groups innovating with novel ways to tackle the problems facing engineered grafts. For example, grafts comprising decellularized ECM on biodegradable scaffolds have been suggested to serve as readily available TEVGs; these have been tested in a variety of animals models (Dahl et al, 2011) and can exploit recent advances in 3D tissue printing to provide patient-specific grafts (Fukunishi et al, 2017;Best et al, 2018). Cell-free vessel grafts have been generated by allowing cells to secrete ECM for longer periods to more closely mimic the in vivo environment and are then decellularized (Lawson et al, 2016;Row et al, 2017).…”

Current and future applications of 3D printing in congenital cardiology and cardiac surgery

“…The use of the models may facilitate the development of new devices and new surgical techniques, also beyond CHD, whilst the combination of 3D models with tissue engineering could lead to bioprinting patient-specific grafts and heart valves. 14,15 concluSion All imaging modalities (CT, MRI and echocardiography) have developed towards 3D reconstruction techniques, implicitly suggesting the clinical need of going beyond the traditional 2D evaluation of cardiac structures and better appreciating CHD anatomy. Despite its attractiveness, scientific evidence of the usefulness of 3D printing in CHD there is still lacking, and several factors still prevent its becoming widely available or embedded in clinical centres.…”

Fabrication Techniques for Vascular and Vascularized Tissue Engineering

“…Many grafts fabricated through these techniques are currently being assessed in large animal in vivo studies and clinical trials, and the results are reviewed elsewhere . The recent development of sophisticated 3D printing techniques has led to the potential for cell‐encapsulated patient‐specific vascular graft fabrication . For prevascularized tissue‐engineered constructs, interconnected meso‐ and microchannels have been fabricated using techniques such as electrospinning, molding, 3D printing, and laser degradation of scaffold materials .…”