MTissue Engineering to Build a Heart Heart failure afflicts millions of people worldwide. These people might be helped by a heart transplant (1), but donor hearts are much fewer than needed, and the recipients have to struggle with complications related to immune rejection of foreign tissue (2). Ott and colleagues have explored an alternate solution to the problem (3). Doing a test study on rats, the authors began with hearts removed after death. Washing the hearts thoroughly inside and out with a mix of detergents effectively removed all the cells from the hearts. What was left behind was a scaffold of extracellular materials, the stuff that normally resides between cells and provides some structure to a tissue. The main chambers of the heart, the valves that control blood flow, and key cardiac blood vessels were all represented in this bald structure. In a next step, the authors isolated cardiac muscle cells from neonatal rat hearts. These very young cells were then added back to the de-cellularized heart scaffold, where they took up residence. Addition of endothelial cells re-established the correct lining for the blood vessels. After 8 days in laboratory conditions, this re-constructed heart was able to sustain its own contractions and respond appropriately to pharmacological stimulus. These studies tested the process with rat hearts and with rat cells that were already in the cardiac lineage. Bringing the technology to the human situation will require further studies to understand what works best. However, these studies in the rat do suggest that in future, patients with heart failure might be treated with materials that are both more readily available and less complicated by immune rejection than current sources of organ donation. (Ott et al., 2008) 1. MedlinePlus Medical Encyclopedia, ‘Heart transplant’, 2. MedlinePlus Medical Encyclopedia, ‘Immune reaction’, 3. Ott, H. C., Matthiesen, T. S., Goh, S. K., Black, L. D., Kren, S. M., Netoff, T. I., and Taylor, D. A. (2008). Perfusion-decellularized matrix: using nature's platform to engineer a bioartificial heart. Nat Med 14, 213-221. *Author affiliation Posted March 21, 2008
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