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Tissue-engineered breast reconstruction: bridging the gap toward large-volume tissue engineering in humans
Michael W Findlay1, Juergen H Dolderer, Nicholas Trost
1Fitzroy and Parkville, Victoria, Australia From the O'Brien Institute, the University of Melbourne Department of Surgery; the Department of Medical Imaging, St. Vincent's Hospital Melbourne; and the Department of Chemical and Biomolecular Engineering, the University of Melbourne.
This study scaled up adipose tissue engineering in pigs, successfully creating clinically relevant tissue volumes for breast reconstruction. The engineered tissue demonstrated significant expansion and vascularization, paving the way for human trials.
Area of Science:
- Biomaterials Science
- Regenerative Medicine
- Plastic Surgery
Background:
- Autologous tissue is ideal for breast reconstruction but limited by donor site morbidity and insufficient tissue volume.
- Tissue engineering offers a solution for creating replacement tissue, provided large volumes can be vascularized.
- This study aimed to scale up small-animal adipose tissue engineering models to produce large tissue volumes in pigs.
Purpose of the Study:
- To evaluate the feasibility of upscaling adipose tissue engineering for breast reconstruction.
- To assess the vascularization and volume expansion of engineered adipose tissue in a large animal model.
- To determine the potential for translating these findings to human clinical trials.
Main Methods:
- Large-volume (78.5 ml) subcutaneous chambers were implanted in pigs, enclosing a 5 ml fat flap based on the superficial circumflex iliac pedicle.
- Chambers were maintained for 6, 12, and 22 weeks, with some including a poly(L-lactide-co-glycolide) sponge.
- Tissue growth and vascularization were serially assessed using magnetic resonance imaging and confirmed with histomorphometry.
Main Results:
- Engineered chambers were filled with new tissue and vascularized by the arteriovenous pedicle within 6 weeks.
- The initial 5 ml fat flap expanded significantly, reaching 56.5 ml by 22 weeks.
- Engineered adipose tissue volume was maintained up to 22 weeks, with successful in situ transfer to a submammary pocket.
Conclusions:
- Clinically relevant volumes of engineered adipose tissue were successfully generated in a large animal model.
- This study demonstrates the potential for scaling up existing tissue-engineering models for breast reconstruction.
- The findings have significant implications for advancing tissue engineering towards human clinical applications.
