Diaphragmatic reconstruction with autologous tendon engineered from mesenchymal amniocytes
Section snippets
Materials and methods
The current study was approved by the Harvard Medical School Standing Committee on Animals, under protocol # 03354.
Results
Fetal and neonatal survival rates were 100%. On gross inspection (Fig 1), diaphragmatic hernia recurrence was significantly higher in animals with acellular grafts (5 of 5) then in animals with cellular implants (1 of 4) in group I (P < .05), but not in group II (3 of 6 and 4 of 5, respectively). There was no evidence of chest wall deformity in either experimental group. Cellular grafts showed higher modulus (5.27 ± 1.98 v 1.27 ± 0.38 MPa; P < .05) and ultimate (1.94 ± 0.70 v 0.29 ± 0.05 MPa; P
Discussion
Three reasons led us to explore the concept of engineering a tendon, instead of a muscle patch, for diaphragmatic repair: (1) except for the rare cases of complete diaphragmatic agenesis, the native diaphragmatic muscle seems to develop and function normally in the majority of children with CDH (2) a sizeable portion of the normal diaphragm is comprised of a tendon, and (3) meaningful muscular function driven by substantial nerve ingrowth from the host is yet to be shown in engineered skeletal
References (19)
- et al.
ECMO and the management of congenital diaphragmatic hernia with large diaphragmatic defects requiring a prosthetic patch
J Pediatr Surg
(1992) - et al.
Patch incorporation in diaphragmatic hernia
J Pediatr Surg
(2000) - et al.
Fetal tissue engineeringDiaphragmatic replacement
J Pediatr Surg
(2001) - et al.
Prosthetic patch durability in congenital diaphragmatic herniaA long-term follow-up study
J Pediatr Surg
(2001) - et al.
Reconstruction of congenital agenesis of hemidiaphragm by combined reverse latissimus dorsi and serratus anterior muscle flaps
J Pediatr Surg
(2001) - et al.
Prosthetic diaphragm reconstruction in the growing animal
J Pediatr Surg
(1993) - et al.
Lyophylized dura patch repair of congenital diaphragmatic herniaOccurrence of relapses
J Pediatr Surg
(1993) - et al.
Collagen-coated Vicryl mesh is not a suitable material for repair of diaphragmatic defects
J Pediatr Surg
(1997) - et al.
Evaluation of small intestine submucosa and acellular dermis as diaphragmatic prostheses
J Pediatr Surg
(1999)
Cited by (140)
Neonatal stem cells in tissue engineering
2020, Principles of Tissue EngineeringFetal Tissue
2019, Encyclopedia of Tissue Engineering and Regenerative Medicine: Volumes 1-3Synthesis of hydrogels and their emerging role in pharmaceutics
2019, Biomedical Applications of NanoparticlesScaffolds for reconstruction of the diaphragm
2019, Handbook of Tissue Engineering Scaffolds: Volume TwoFetal tissue
2019, Encyclopedia of Tissue Engineering and Regenerative MedicineBioengineered kidney and bladder
2019, Encyclopedia of Biomedical Engineering