Blood vessels are damaged for a wide variety of reasons; but especially due to diabetes and arteriosclerosis (hardening of the arteries). These damaged blood vessels become inflamed, and degeneration is progressive. Of course, the ultimate consequences of this process is significant: outcomes range from heart attacks, strokes, kidney failure, peripheral vascular disease, neurological manifestations, etc.
Our medical interventions historically have been to fix the outcomes. Heart surgery, anti-clotting medications, preventive exercise and diet, and a wide variety of other interventions are done to repair the damage. Now, Cytograft Tissue Engineering of Novato, Calif., is making blood vessels from the person’s own skin. The process takes about 6 to 9 months. Rejection is eliminated, as the person’s own anatomy is being used. Additionally, inflammatory processes are reduced, as synthetic plastics are not needed.
These grafts have been used on eight patients, and have been successful. Additionally, many surgeons see these grafts having many benefits for children, who are born with birth defects. Unlike grafts from cadavers, the living tissue should allow the vessel to grow as the child grows.
The procedure for grafting cells from one’s own skin is awesome all by itself. “The skin biopsy takes about 15 minutes. Under local anesthesia, a doctor removes a piece of skin, including a strip of vein about an inch long, from the back of the hand or inner wrist. Then technicians use enzymes to extract fibroblast cells from the skin and endothelial cells from the inner lining of the vein. The cells are grown by the millions as sheets in a laboratory. The fibroblasts provide a mechanical backbone for the sheets that are peeled and rolled into a tube.
Although the vessel resembles a vein under the microscope, it has the mechanical strength of an artery. The technique allows the body over time to remodel the cells from a vein into a vessel with the elasticity of an artery.” (NYT, 2007)
The above grafts have all been done in Argentina, as medical costs are not as excessive as in America. But other countries are starting to get on the band wagon. Poland is currently recruiting candidates who require Coronary By-Pass Surgery. Additional recruits are those diabetic patients who are scheduled to have limb amputations as a result of the damage done to the vascular system. Grafts in both of these cases, if successful, have significant implications for all of us.
Sources
“Blood Vessels Grown From Patient’s Skin”: New York Times, October 9, 2007.
http://www.nytimes.com/2007/10/09/health/09vess.html?th&emc=th
Tissue-Engineered Blood Vessel for Adult Arterial Revascularization: New England Journal of Medicine, October 4, 2007
http://content.nejm.org/cgi/content/full/357/14/1451
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