Inflammatory responses of tissue-engineered xenografts in a clinical scenario

Acellular tissue-engineered (ATE) xenografts and homografts are used in clinical cardiovascular surgery. The present study examined the specific role of carbohydrate antigen (α-Gal and T-antigen) in immune response after decellularisation in tissue-engineered xenografts (porcine pulmonary artery and bovine jugular vein). An enzyme-linked immunosorbent assay (ELISA) was used to ascertain whether implantation of bioprostheses, ATE xenografts and mechanical valve replacement result in augmentation of anti-α-Gal IgM antibodies within eight days of surgery (each group, n=6). Kinetics of host inflammatory response on surgically explanted ATE xenografts was also studied. Immunostaining for α-Gal and T-antigen detected the presence of them in the native tissue but they were absent in processed ATE xenografts from the same tissue. A significant increase in the concentration of anti-α-Gal IgM antibodies was observed in the serum of bioprosthetic valve recipients as compared to ATE xenograft recipients (P<0.05). Organised collagen, and decreased inflammatory response with increase in endothelisation and vascularisation was evident beyond one year of surgery as compared to early periods in ATE xenografts. This study demonstrates that decellularisation of xenografts and further processing of these tissues enabled reduction of inflammatory stimulus with autologous recellularisation with no calcification.