In a major step forward for tissue engineering, surgeons at Duke University have successfully implanted a bioengineered blood vessel into the arm of a patient with end-stage kidney disease. The procedure is the first of its kind in the US, and one of the first such efforts worldwide.
The vessels could replace synthetic grafts
The engineered vein was created with donated human blood vessel cells, which are implanted onto a tubular, biodegradable scaffold. The scaffold supports those cells as they grow into a fully-formed vessel. Once the process is complete, the new vein is "scrubbed" of cellular properties that might trigger an immune response — and subsequent rejection — in a patient. Where kidney disease is concerned, the vessels could replace synthetic grafts used to link an artery to a vein for the process of hemodialysis. Such synthetics are accompanied by serious risks, including clotting and infection.
The technique might one day yield blood vessels for other procedures
"We hope this sets the groundwork for how these things can be grown, how they can incorporate into the host, and how they can avoid being rejected immunologically," said Jeffrey Lawson, MD, PhD, a vascular surgeon who helped develop the veins. Indeed, the technique might one day yield blood vessels for other procedures, namely heart bypass surgery.
For now, the Duke team is focused on conducting several more surgeries on patients suffering from kidney disease: this operation was only the first in an FDA-approved clinical trial that'll evaluate the safety of the veins on a total of 20 patients. And because the veins are engineered to be universal — rather than personalized for each patient — they might one day be mass produced for on-demand availability.