Transplantation of an allogeneic vein bioengineered with autologous stem cells: a proof-of-concept study

摘要: Summary Background Extrahepatic portal vein obstruction can have severe health consequences. Variceal bleeding associated with this disorder causes upper gastrointestinal bleeding, leading to substantial morbidity and mortality. We report the clinical transplantation of a deceased donor iliac graft repopulated recipient autologous stem cells in patient extrahepatic obstruction. Methods A 10 year old girl was admitted Sahlgrenska University Hospital Gothenburg, Sweden, for bypass procedure between superior mesenteric intrahepatic left (meso Rex bypass). 9 cm segment allogeneic decellularised subsequently recellularised endothelial smooth muscle differentiated from obtained bone marrow recipient. This used because patient's umbilical not suitable other strategies (eg, liver transplantation) require lifelong immunosuppression. Findings The immediately provided functional blood supply (25–30 cm/s 40 mL/s artery measured intraoperatively confirmed ultrasound). had normal laboratory values months. However, at 1 flow low and, on exploration, shunt patent but too narrow due mechanical tissue mesocolon. Once causing compression removed dilated. therefore second stem-cell populated lengthen previous graft. After operation, pressure reduced 20 mm Hg 13 25–40 vein. With restored circulation has substantially improved physical mental function growth. no anti-endothelial cell antibodies is receiving immunosuppressive drugs. Interpretation An acellularised be considered patients need vascular shunts without Funding Swedish Government.