Abstract
The aim of this study is to assess the biological behaviour of porcine decellularized heterografts (Desc group) compared with cryopreserved homografts (Crio group) implanted in juvenile sheep. Decellularized porcine pulmonary heterografts were implanted in five animals and cryopreserved pulmonary homografts in another five. The animals were followed-up for a mean of 280 +/- 14 days. The valve diameter was measured by echocardiography, which was performed at the 30th postoperative day, and before the explantation. The valves were also assessed macroscopically. Histological evaluation was performed using H.E., Gomori and Weigert staining. Immunohistochemistry specified different cell types (Factor VIII, CD3, Vimentin and CD68). Calcium quantity was analyzed using atomic absortion spectometry. There was one death in the Desc group due to endocarditis. The valves of Crio group showed decrease in the cellularity whereas the valves of Desc group showed matrix repopulation with endothelial and interstitial cells. Loss of collagen density and disarrangement of the normal fiber architecture was observed in Crio group. Calcium content demonstrated higher levels on the cusps and conduits in Crio group comparatively with Desc group. (P=0.016). The mean valvular diameter at the explantation was significantly increased (P=0.025) in the Desc group. Decellularized heterografts had a different biological behaviour when compared to cryopreserved homografts and become repopulated by cells with fibroblasts and endothelial cells characteristics. The matrix was preserved and some regenerative potential was present.
Highlights
The cryopreserved grafts are frequently used to treat different types of heart valve diseases and various types of complex congenital heart diseases
Recent studies suggest that decellularized heterografts lead to a reduced inflammatory response by the receiver and are able to be progressively repopulated by autologous cells
This study consists of a comparative study of cryopreserved homografts and decellularized heterografts implanted in orthotopic position in the right ventricle outflow tract of of sheep by using cardiopulmonary bypass
Summary
The cryopreserved grafts are frequently used to treat different types of heart valve diseases and various types of complex congenital heart diseases. In such cases the homografts present a better hemodynamic profile, low incidence of thromboembolism and greater resistance to infection, its durability is limited, especially in children and young patients [1]. Recent studies suggest that decellularized heterografts lead to a reduced inflammatory response by the receiver and are able to be progressively repopulated by autologous cells. These factors allow, at least in theory, improvement of late survival of the grafts implanted [3,4,5]
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