Abstract
BackgroundDespite advances in transplant surgery and general medicine, the number of patients awaiting transplant organs continues to grow, while the supply of organs does not. This work outlines a method of organ decellularization using non-thermal irreversible electroporation (N-TIRE) which, in combination with reseeding, may help supplement the supply of organs for transplant.MethodsIn our study, brief but intense electric pulses were applied to porcine livers while under active low temperature cardio-emulation perfusion. Histological analysis and lesion measurements were used to determine the effects of the pulses in decellularizing the livers as a first step towards the development of extracellular scaffolds that may be used with stem cell reseeding. A dynamic conductivity numerical model was developed to simulate the treatment parameters used and determine an irreversible electroporation threshold.ResultsNinety-nine individual 1000 V/cm 100-μs square pulses with repetition rates between 0.25 and 4 Hz were found to produce a lesion within 24 hours post-treatment. The livers maintained intact bile ducts and vascular structures while demonstrating hepatocytic cord disruption and cell delamination from cord basal laminae after 24 hours of perfusion. A numerical model found an electric field threshold of 423 V/cm under specific experimental conditions, which may be used in the future to plan treatments for the decellularization of entire organs. Analysis of the pulse repetition rate shows that the largest treated area and the lowest interstitial density score was achieved for a pulse frequency of 1 Hz. After 24 hours of perfusion, a maximum density score reduction of 58.5 percent had been achieved.ConclusionsThis method is the first effort towards creating decellularized tissue scaffolds that could be used for organ transplantation using N-TIRE. In addition, it provides a versatile platform to study the effects of pulse parameters such as pulse length, repetition rate, and field strength on whole organ structures.
Highlights
Despite advances in transplant surgery and general medicine, the number of patients awaiting transplant organs continues to grow, while the supply of organs does not
This effort is the first step towards creating decellularized tissue scaffolds that could be used for organ transplantation
Because non-thermal irreversible electroporation (N-TIRE) procedures are dependent on the electric field to which a region of tissue is exposed, and thermal effects are mitigated by brief pulses with intervals between pulses, it is possible to scale up N-TIRE procedures to treat larger regions of tissue and organs
Summary
Despite advances in transplant surgery and general medicine, the number of patients awaiting transplant organs continues to grow, while the supply of organs does not. Over the past fifty years, organ transplantation has become a standard care for patients diagnosed with end stage organ failure including cirrhosis and renal failure. The number of patients with cirrhosis, chronic viral hepatitis and hepatocellular carcinoma has steadily increased, leading to unmet demands for organ transplantation [1]. According to the United Network of Organ Sharing (UNOS), there are over 108,000 candidates in the US alone currently waiting for organ transplants including kidney, liver, heart, and lung. Despite advances in transplant surgery and general medicine, the number of patients awaiting transplant organs continues to grow, while organ supply does not. Organ supply is constrained by obstacles that impede acquisition, such as the requirement for organ removal coincident with brainstem death necessitating the use of hospital resources to maintain artificial life support. Life support for potential organ donations has been ethically debated[4,5] and donation refusal is common in regions where social, cultural, and religious pressures constrain organ procurement
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