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False blood vessels begin to become real.
New research shows that "bioengineered" blood vessels are able to incorporate living cells after they have been implanted into the human body, becoming self-healing, blood-carrying tubes that function less as surrogate vessels human blood and look more like reality.
The so-called human acellular vessels (HAVs) are experimental devices and are not yet ready for widespread use. But if new research is supported by later studies, HAVs may one day be used to treat medical problems ranging from cardiovascular disease to gunshot wounds.
"This is the wave of the future," said Lola Eniola-Adefeso, a professor of biomedical engineering at the University of Michigan, who did not participate in the research, described the March 27 in the journal Science Translational Medicine.
For research, scientists and biomedical engineers from Yale University and Humacyte, a regenerative medical technology company based in Durham, North Carolina, have created HAV by harvesting arterial cells from corpses, growing them in new ships and then removing them. After the treatment, only the so-called cell matrix remained – the network of collagen and proteins that gives structure to a vessel.
Science
Then, HAVs were implanted in the arms of 60 patients with kidney failure in Durham; Norfolk, Virginia; and three cities in Poland. HAVs were used during hemodialysis sessions three times a week, the blood cleansing treatment that takes over sick kidneys.
Hemodialysis is usually administered through a fistula, a surgical link between an artery and an easy-to-access vein; or by a graft, which connects the two blood vessels by a synthetic tube. Both approaches have disadvantages: Not all patients are good candidates for fistulas and grafts are prone to clots and infections.
Researchers followed patients for three years after receiving their implants. Whenever a participant underwent routine surgery to repair or maintain his implant, the researchers took a tiny square of their artificial vessel. In total, the researchers obtained samples from 13 patients. Subsequent badysis of the samples showed that the predefined matrix was filled with the patient's own cells.
"Your own stem cells enter spaces, realize that they are in a blood vessel, and then differentiate into your own tissue," said Humacyte CEO Jeffrey Lawson.
The badysis also showed that the artificial vessels were able to heal themselves. In one sample, extracted about 10 months after implantation, new cells developed around needle-drilled holes during dialysis.
Eniola-Adefeso qualified the results as promising, but added that there was much to learn about the performance of vessels, including their long-term retention capacity.
Yale and Humacyte scientists are also looking to the future. Lawson said that artificial blood vessels could one day be kept in the emergency rooms of the hospital.
"This science fiction concept of tissue engineering – we are about to do it for real," he said.
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