(RxWiki News) Dialysis treatment often requires connecting an artery to a vein with a synthetic vessel or one taken from the patient’s body. A lab-made vein may revolutionize this surgery.
Recently, a team of doctors at Duke University Hospital successfully transplanted a bioengineered blood vessel into the arm of a patient with end-stage kidney disease.
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Jeffrey Lawson, MD, PhD, a vascular surgeon and vascular biologist at Duke Medicine in Durham, North Carolina, helped develop the technology and performed the implantation.
In a solution of amino acids, vitamins and nutrients, donated human cells were grown around a tube-shaped mesh scaffold that shaped the cells into a blood vessel. Over a couple months, the mesh structure gradually dissolved and a life-like vein was created.
The scientists introduced a pulsing force to the growth process. This means nutrients were pumped through the lab-made vessel in a pulse that mimicked the heartbeat so it could build properties that are similar to natural blood vessels.
The bioengineered vessel was also cleansed of qualities that might trigger an immune response.
Originally, the researchers sought to develop veins using a person’s own cells because this would reduce the risk that the patient’s body would reject the implanted tissue.
Growing personalized veins, however, took too much time and the process ruled out the possibility of mass production. The scientists then changed their tack to develop a universal product.
The bioengineered vein is the result of a 15-year collaboration between Dr. Lawson and Laura Niklason, MD, PhD, a former faculty member at Duke University who is now at Yale. She is also one of the founders of Humacyte, a medical technology company, that helped develop the lab-made blood vessel.
Dr. Lawson and Dr. Niklason teamed up in the late 1990s after discovering they shared an interest in engineering blood vessels.
The first human implantations of these blood vessels began in clinical trials in Poland in December. The US Food and Drug Administration recently approved a phase 1 trial involving 20 kidney dialysis patients in the United States, followed by a safety review.
The initial trial focuses on implanting the vessels in an easily accessible site in the arms of kidney hemodialysis patients.
With kidney failure patients, the kidneys can no longer filter wastes, extra salt and extra water from the blood. Hemodialysis filters blood outside of the body and returns it to the patient. Hemodialysis often requires a graft to connect an artery to a vein to speed blood flow during treatment.
Current options for grafts have drawbacks. Synthetic vascular grafts are prone to clotting, leading to frequent hospitalizations, and harvesting veins from a patient’s own body involves a separate procedure, with the risk of infection and other complications.
If the bioengineered veins prove beneficial for hemodialysis patients, the researchers ultimately aim to develop readily available and durable grafts for heart bypass surgeries and blocked blood vessels in the limbs.
“We start with this, and one day we may be able to engineer a liver or a kidney or an eye,” said Dr. Lawson in a press release from Duke University.
The surgery was performed in June at Duke University Hospital in Durham, North Carolina.
