A New Method for Preparation of Decellularized Human Scaffolds for Facial Reconstruction

Vascularized composite allotransplantation (VCA) has emerged as a robust alternative for addressing anatomically complex defects but requires a toxic lifelong immunosuppressive regimen. Tissue engineering offers the promise of creating recipient-specific alternative grafts using a decellularization and recellularization approach. In this article, we establish a reliable protocol for human face decellularization by immersion as a new tool in the development of engineered graft alternatives for reconstructive surgery. Three cadaveric face grafts were immersed in 1% sodium dodecyl sulfate for 216 h followed by 1% Triton X-100 for 48 h, without perfusion through the pedicle. We determined that decellularization was successfully accomplished for three facial specimens as confirmed by histological evaluation and quantification of DNA content. The extracellular components including collagen, glycosaminoglycans, elastin, and matrix-bound growth factors were preserved. Vascular architecture did not show significant differences between native and decellularized grafts as imaged by X-ray angiography. The mechanical strength of the grafts was not altered after decellularization. We also showed that the decellularized grafts were biocompatible in vitro and in vivo allowing cell engraftment. As a result, we have successfully developed a protocol to yield a clinical size decellularized graft suitable for generating a recellularized, potentially non-immunogenic graft for facial reconstruction.