American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

New approaches engineer vascularized soft tissue

OCTOBER 25, 2017
Clinical Congress Daily Highlights, Wednesday Second Edition

Soft tissue losses from aging, trauma, or congenital malformation affect millions of people each year. Existing options for soft tissue restoration have significant drawbacks: autologous flaps cause donor-site defects; prosthetics are prone to foreign-body response; fat grafting and dermal fillers are limited to small volume defects, and provide only transient volume restoration. Engineered tissue has shown promise as a successor to these approaches, but has several drawbacks, especially the risk of insufficient vascularization.

Three teams presented new technologies at Clinical Congress that offer ways to vascularize tissue, grow vascularized tissues in vitro, and promote soft tissue regeneration.

Andrew I. Abadeer of Weill Cornell Medical College, Columbia University College of Physicians and Surgeons, New York, NY, and his colleagues reported that they have figured out a way to better vascularize tissue for use by reconstructive surgeons. They fabricated a unique prevascularized regenerative template with an inherent hierarchical vasculature that exploits the powerful angiogenic regulator, sphingosine-1-phosphate (S1P), a bioactive sphingolipid stored in platelets. This is a significant development, because the clinical applicability of current dermal replacement products is limited by the absence of an inherent vasculature.

A group led by John Morgan, MD, PhD, Cornell University Medical College, New York, NY, presented autonomous tissue cartridges (ATC) that recapitulate microvasculature in vitro. The researchers conclude that this technology sets the stage for clinical translation of pre-vascularized tissues, provides new insights into relationships between hemodynamic forces and cell morphology/dynamics, and advances studies of mechano-biology to identify molecular mechanisms by which cells sense shear stress.

Researchers led by Brian Cho, MD, Johns Hopkins University School of Medicine, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, discussed their development of a nanofiber-hydrogel composite to promote vascular ingrowth, survival, and migration of transplanted human adipose-derived stem cells (hASCs) for soft-tissue regeneration. This composite scaffold promotes angiogenesis, soft tissue ingrowth, and enables delivery of hASCs and tissue regeneration for treatment of soft tissue defects. The authors conclude that it holds high potential for clinical translation to improve soft-tissue restoration in the clinical setting.

Additional Information:
The three Scientific Forum studies presented at the 2017 Clinical Congress of the American College of Surgeons Clinical Congress in San Diego, CA were: Push to Start: Engineering a Hierarchical Vasculature for Surgically Applicable Tissues; Growing Vascularized Tissues In Vitro Using an Autonomous Tissue Cartridge; Composite-Mediated Angiogenesis and Stem Cell Transplantation for Soft Tissue Regeneration. Program, webcast and audio information is available online at FACS.org/clincon2017.

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