Autologous Recellularization of a Vein Transplant Feasible
Proof-of-concept study shows recellularization of dead donor vein graft restores portal blood flow
THURSDAY, June 14 (HealthDay News) -- A new technique involving recellularization of a deceased donor vein graft with autologous stem cells may be a viable option for patients who require a vein graft, according to a proof-of-concept study published online June 14 in The Lancet.
Michael Olausson, M.D., from the University of Gothenburg in Sweden, and colleagues describe the case of a 10-year-old girl with extrahepatic portal vein obstruction admitted for a bypass procedure between the superior mesenteric vein and the intrahepatic left portal vein. A graft was produced by decellularization of a 9-cm segment of iliac vein from a deceased donor, which was subsequently recellularized with endothelial and smooth muscle cells differentiated from stem cells taken from the bone marrow of the recipient.
The researchers found that, immediately after the transplant, the graft provided the recipient with a functional blood supply. Normal laboratory values were seen for nine months, but at one year, the blood flow was low. Exploration revealed that the shunt was patent but mechanical obstruction of tissue in the mesocolon caused narrowing. A second stem-cell-populated vein graft was used to lengthen the earlier graft. Following the second operation, blood flow was restored and portal pressure decreased. Physical and mental function and growth improved with restored portal function. The patient did not have anti-endothelial cell antibodies and did not receive immunosuppressant medication.
"An acellularized deceased donor vein graft recellularized with autologous stem cells can be considered for patients in need of vascular vein shunts without the need for immunosuppression," the authors conclude.
One author disclosed receiving royalties from Absorber AB, which developed the XM-ONE kit used in the study.