The invention relates to a system for storing or cultivating of an organ or tissue model having a flow or vascular system and to a use thereof. The system is designed for, including without limitation, verifying the functioning of a harvested organ or a tissue model and allows for treating it. The system may be used to cultivate organs or tissue models harvested from donors and/or produced using other techniques, such as using 3D and/or 4D bioprinting or electrospinning technology. The system may be used for the flow culture of organs that cannot be harvested or treated otherwise in a patient. The term “organ flow system” relates to artificially produced organs and denotes a system with formed channels. The term “organ vascular system” denotes a system of vessels with endothelial cells, either harvested from donors or produced artificially. The term “storing” relates to keeping an organ or a tissue model at a low temperature at reduced metabolism or prior to colonisation with cells. The term “cultivating” relates to keeping an organ or a tissue model colonised with cells in a normothermic environment corresponding to in vivo conditions. The term “tissue model” denotes a three-dimensional structure containing living cells suspended in a biomaterial, which may additionally contain a vascular system.
U.S. Pat. No. 9,756,851B2 discloses a composition, a method and a device for keeping a harvested organ viable before implantation. The organ perfusion device comprises a preservation chamber for storing the organ. A perfusion circuit is provided with the first line for supplying oxygenated fluid to the organ and a second line for discharging used fluid from the organ. The perfusion device also comprises a device functionally connected to the perfusion circuit for keeping the organ at a generally normothermic temperature. In addition, the device contains means for controlling pressure of the perfusion fluid, oxygenation means for oxygenating at least some of said fluid, filtration means and flow control means for controlling the flow of at least some of said fluid.
Patent document WO1996029865A1 describes an organ perfusion apparatus capable of perfusing organs at temperatures close to normal, using blood or other oxygen-carrying substances. The apparatus allows to assess the viability of organs using on-line measurements of physiological efficiency. Embodiments use a computer-controlled blood pump in order to characterise physiological conditions of perfusion. The apparatus comprises parts that allow for replenishing lost circulating volume and for infusing nutrients, medicaments and components of perfusion fluid in order to help to maintain or regenerate organs. The apparatus can also adjust pressure, pH and temperature, automatically measure rate of production of urine, bile, pancreatic duct secretions or other physiological exudates, and determine flowrate of blood or perfusate, vascular resistance and organ swelling.
US2017339945A1 discloses an apparatus for multi-organ perfusion, selected from a group comprising heart, liver, kidneys and lungs, comprising a base unit, configured to be detachably connected to a perfusion module for organ perfusion. The base unit is provided with tubes to connect a perfusate source to the organ so that perfusate circulates through the organ, first and second pumps, connected to the tubes for driving circulation of the perfusate in the tubes and a controller, configured and connected to control the first and second pumps in order to control the circulation of the perfusate through the organ. The controller can control the first and second pumps for the purposes of organ perfusion depending on perfusion parameters selected, based on the type of organ.
Document EP1879997A2 discloses a portable organ perfusion device with an organ chamber for supporting an organ immersed in perfusion fluid. The pump circulates the perfusion fluid around a circuit containing a pump, a heat exchanger for cooling the perfusion fluid, an oxygenator to oxygenate the perfusion fluid and a device for ensuring a constant supply of fluid to the organ vascular system. A by-pass channel provides a fluid connection, allowing excess fluid to bypass the organ. The device further comprises an oxygen source, sensors, a power supply and a control unit for receiving information from sensors and providing control instructions to the control means.
Solutions are being sought that would ensure efficient control of maintaining normothermic conditions, regulation of fluids or pH control for an efficient, more automatic and accurate repair or cultivating of organs and tissue models. The objective of the invention is to provide suitable conditions for cultivating and storing organs harvested from deceased donors, such as pancreas, liver, kidney, lung, heart, small intestine, large intestine, thyroid, skin, brain, or produced using other techniques, e.g. using 3D and/or 4D bioprinting technology such as tissue models printed with a vascular system. The term “bionic organs” relates to both tissue models printed in 3D and/or 4D technology directly with cells, and scaffolds alone (vascular systems and tissue models), which are only subsequently colonised with respective cells. The term “3D bioprinting” relates to a formation of three-dimensional structures containing viable cells using additive manufacturing technologies (layer-by-layer material application). In 4D bioprinting, fourth dimension is time, and the technique yields bands of materials that are formed to later transform into a previously defined object (shape).
In a first aspect of this invention, a system is provided for storing or cultivating an organ or a tissue model, preferably harvested from a donor, preferably selected from pancreas, liver, kidney, lung, heart, small intestine, large intestine, thyroid, skin, brain, or produced using other techniques, preferably using 3D bioprinting and/or 4D bioprinting and/or electrospinning technologies, preferably in a form of organs and/or tissue models printed with flow or vascular systems, comprising:
The perfusion fluid flow output denotes the perfusion fluid flow rate, expressed in a unit of volume per unit of time. The term “organ chamber” denotes a chamber suitable for storing or cultivating of an organ or tissue model.
Preferably, the system for storing or cultivating an organ or tissue model comprises system control means, configured and programmed to obtain measurement values for at least one parameter selected from: temperature of the perfusion fluid in the organ chamber, temperature of the perfusion fluid in the perfusion fluid container, concentration of glucose in the perfusion fluid, pH of the perfusion fluid, parameters of perfusion fluid flow, including pressure of the perfusion fluid and/or output of the perfusion fluid, expressed as a unit of volume per unit of time, concentration of lactates in the perfusion fluid, concentration of sodium ions in the perfusion fluid, concentration of chlorine ions in the perfusion fluid and concentration of potassium ions in the perfusion fluid, oxygenation, wherein the system control means are further configured and programmed for automatic and/or manual adjustment based on predetermined criteria of at least one parameter selected from: temperature of the perfusion fluid in the organ chamber, temperature of the perfusion fluid in the perfusion fluid container, concentration of glucose in the perfusion fluid, pH of the perfusion fluid, parameters of perfusion fluid flow, including pressure of the perfusion fluid and/or output of the perfusion fluid, lactate concentration in the perfusion fluid, sodium ion concentration in the perfusion fluid, chlorine ion concentration in the perfusion fluid and potassium ion concentration in the perfusion fluid, oxygenation.
Preferably, the system for storing or cultivating an organ or tissue model further comprises means for measuring and controlling the oxygenation of perfusion fluid and/or means for air removal form the perfusion fluid, wherein the system control means are preferably configured and programmed to obtain perfusion fluid oxygenation measurement values and automatic and/or manual adjustment of perfusion fluid oxygenation based on predetermined criteria.
Preferably, the system for storing or cultivating an organ or tissue model further comprises means for measuring of loss and replenishment of the perfusion fluid, preferably based on a reading of weight of the perfusion fluid removed from the system, wherein the system control means are preferably configured and programmed for automatic and/or manual replenishment of the perfusion fluid based on predetermined criteria.
Preferably, the means for contactless mixing of the perfusion fluid are provided as a swinging mechanism for swinging of the perfusion fluid container, wherein the system control means are preferably configured and programmed to automatically and/or manually adjust the swinging of the perfusion fluid container.
Preferably, oxygenation of the perfusion fluid is performed with an oxygenator, which is peripherally connected to the perfusion fluid container to form an oxygenator circuit, and the means for mixing the perfusion fluid are provided in a form of a cylindrical design of the perfusion fluid container, in which, during operation of the system, the perfusion fluid is mixed by placing the inlet and outlet of the oxygenator circuit on opposite sides of the perfusion fluid container, tangentially to the cylindrical walls of the perfusion fluid container.
Preferably, the system comprises means for taking samples of the perfusion fluid.
Preferably, the organ chamber comprises a rotating mechanism which allows the organ chamber to rotate during operation of the system, wherein the system control means are preferably configured and programmed to automatically and/or manually adjust the rotation of the organ chamber. Preferably, the system control means are configured and programmed to rotate the organ chamber by 180° every 30 minutes for at least two hours or at least four times by 90° every 15-60 minutes for at least two hours.
Preferably, the organ chamber and/or the perfusion fluid container and/or the means for measuring and controlling the oxygenation of the perfusion fluid has/have means for adjusting temperature in the range from 0 to 37° C.
Preferably, the system further comprises additional means for dosing medicaments and/or nutrients and/or perfusion fluid components, wherein the system control means are preferably configured and programmed for automatic and/or manual dosing of medicaments and/or nutrients and/or perfusion fluid components based on predetermined criteria.
Preferably, air is removed from the perfusion fluid by means of an air bubble eliminator mounted on the first line between the perfusion fluid container and the organ chamber, and the movement of the perfusion fluid between the perfusion fluid container and the organ chamber and the other way round during operation of the system is performed by means of at least one pump, preferably a peristaltic pump.
In the second aspect, there is provided a use of the system according to the invention for storing and/or cultivating an organ or tissue model harvested from a donor or produced by other techniques, preferably with 3D bioprinting and/or 4D bioprinting and/or electrospinning.
Preferably, the system according to the invention is used for cultivating of a 3D bioprinted organ, wherein preferably the rotation mechanism is used at a stage of colonisation of a vascular system with endothelial cells.
Preferably, a state or development of a disease of an organ or a tissue model is evaluated during storing and/or cultivating.
Preferably, an effect of biologically active substances on the state or development of a disease of an organ or a tissue model is analysed during storing and/or cultivating.
Preferably, the efficacy of a pharmacological and/or gene therapy on the state of an organ or a tissue model is evaluated during storing and/or cultivating.
It is essential to maintain an organ or tissue model in normothermic conditions during cultivation, since it provides optimal metabolic conditions for an organ or a tissue model, corresponding to in vivo conditions, which allow for the condition of the organ to be evaluated.
Perfusion fluid for cultivating harvested organs contains without limitation a concentrate of red blood cells, which tends to sediment. The use of contactless means for mixing the perfusion fluid, preferably in the form of a mechanism that swings the perfusion fluid container or a container configuration that allows for inducing a vortex motion in the container, provides a homogeneous distribution of red blood cells in the perfusion fluid. Also, it allows for keeping the flow system sterile, and the mechanical damage to red blood cells, which occurs when using other types of mixers, is mitigated. The mixing of the perfusion fluid helps to heat the perfusion fluid evenly and constantly mix the components of the fluid.
The rotating mechanism for rotating the organ chamber is used without limitation when cultivating an organ produced by 3D bioprinting technology and is used at the stage of colonisation of the bioprinted vascular system with endothelial cells. Preferably, the rotating mechanism rotates the organ chamber by 180° every 30 minutes for at least two hours or at least four times by 90° every 15-60 minutes for at least two hours. The rotating mechanism enables colonization of the entire vascular system. Rotation is carried out in such a way that the cells have a chance to gravitationally fall on walls of channels and “stick” to them. The rotation may be performed at a smaller angle, e.g. 10 times by 36° for at least two hours, or even continuously—e.g. with a speed of 1 revolution per hour for at least two hours. The use of the rotating mechanism ensures homogeneous distribution of the colonised cells across the channel surface.
The system according to the invention may be used for cultivating and/or storing and/or treating (including regeneration) of the following:
Organs and tissue models cultivated in the system according to the invention may be used in medicine and for basic research as well as research and development work. Moreover, the system according to the invention may be used for cultivating tissue models with flow system (including vascular system), produced by means of 3D/4D bioprinting technology or other techniques that allow for producing models with a flow system (including electrospinning, which consists in obtaining nanofibres from melted polymers or solutions thereof using electric field), such as tissue models with cancerous foci formed, induced disease entities, tissue models suitable for gene therapy studies used for both research and personalised medicine.
The system may be a device used for storing and treating organs prior to transplantation, for testing the effects of biologically active substances, i.e. toxicity and efficacy, and for evaluating the severity of specific disease stages, as well as for evaluating the effectiveness of drug and gene therapies.
Advantageously, the system has a feature of precise dosage of medicaments, active substances and sampling for biological and chemical analyses. This makes it a multifunctional device which, in addition to storing/cultivating and treating organs, allows for conducting advanced research, preparing organs for transplantation and evaluating their functional state. Thus, it will contribute to the improvement of the effectiveness of transplantation procedures and will allow for conducting advanced research (both basic research and the pre-clinical phase).
The invention is illustrated in embodiments in the drawing, where
A pig kidney was used as a model when optimising the functions of the system according to the invention. The use of this organ was dictated by many pragmatic reasons:
Pig kidneys were harvested by interrupting technological cycle of meat production. After stunning an animal by current, it was exsanguinated, and directly after the process was over, the animal was transported to an operation room where the kidney was harvested (warm ischaemia time <10 min.). The harvest was completed when starting the arterial rinsing with UW ice solution (University of Wisconsin Solution). During the exsanguination of the animal, its blood was conserved in a sterile manner (heparinisation).
Composition of a perfusion fluid and conditions of organ cultivation in the system according to the invention:
The system used for cultivation of the pig kidney (
The temperature of the perfusion fluid was adjusted by means of heating-cooling circuits 12 and 13 of the organ chamber 2 and the oxygenator 5, allowing the flow of heating or cooling fluid, heating-cooling circuit of the perfusion fluid container 1, temperature sensor 30 of the organ chamber 2, temperature sensor 31 of the perfusion fluid container 1, and temperature sensor 32 of the oxygenator 5, adjustment system and pumps 9, providing the flow of heating or cooling fluid, which was preferably distilled water, wherein the heating or cooling fluid did not come into contact with the organ or the perfusion fluid, but was only used to transfer heat from the heating device to the heating jacket of the organ chamber 2 and to the heating jacket of the oxygenator 5.
An amount of added fluid was displayed on the operator's panel and, depending on the settings, it could be filled up automatically or manually by the operator of the device using the system controls means.
A main controller of the system control means consisted of two parts: the first one based on a microprocessor 21, which ensured real-time operation by controlling all the peripherals of the device. The second processor 20 was responsible for the graphical interface (GUI), enabling observation and input of parameters.
A TEC controller 23 was designed to control the Peltier modules 27 so that they maintain the perfusion fluid temperature between 0 and 37 degrees C., allowing for handling the organ under both normothermic and hypothermic conditions. Fans 28 were used to control radiator temperature so that the temperature difference between the hot and cold side of the Peltier module is not more than 20° C.
The controller 22 recorded the following temperature measurements: measurement of the Peltier modules 27, measurement of the perfusion fluid heating-cooling plate 11, measurement in the water jacket of the organ chamber 2, measurement in the perfusion fluid container 1.
Several peristaltic pumps 9 were used, the first of which was used for the main perfusion fluid circulation and was controlled to maintain a constant fluid pressure controlled by a tensometric pressure sensor 7. Three more pumps 9 were used to administer medicinal substances. It was possible to administer medicaments at a specific rate in ml/min.
The control panel of the system according to the invention could be accessed from a level of a web browser, so that it could be opened with any device such as a mobile phone, tablet or laptop, provided it had access to the Internet.
The control panel allowed for setting such parameters as: temperature of the heating-cooling plate 11, parameters of the PID controller for temperature control, switching on and off pressure control, preset perfusion fluid pressure [mmHg], minimum and maximum flow (output) of perfusion fluid, presetting speed [ml/min.] of each stepper motor 29, switching on the perfusion fluid mixing mechanism, setting the perfusion fluid mixing speed. The control panel also allowed for monitoring the measured parameters such as pH of the perfusion fluid, glucose concentration in the perfusion fluid, temperature of the heating-cooling plate 11.
A bionic pancreas organ was used to conduct an experiment implemented using 3D bioprinting. The organ comprised a scaffolding, containing pancreatic islets, made of a base bioink and a system of ducts, made of a vascular bioink (
Cultivation process was conducted in controlled temperature conditions: organ chamber 2 temperature in a range between 37 and 39° C.; temperature of heating-cooling plate 11 for heating liquids in a range between 36.5 and 37° C. During the whole experiment, flow and pressure level were also monitored (
A manner of connecting the bionic organ to the organ chamber 2 and monitoring of parameters (pressure, flow, temperature) did not affect structure and function of the vascular system printed in the bionic organ. This was confirmed by a resonance method (
During the incubation of the bionic organ in the organ chamber 2, the following parameters of the perfusion fluid were monitored in real time: oxygenation, pH, glucose concentration, lactate concentration, sodium ions, potassium ions (
Control of parameters allowed for monitoring of composition of the perfusion fluid and, if needed, for improving its quality, which made it possible to maintain the bionic organ in optimum cultivation/incubation conditions. Moreover, the perfusion fluid used in the system was supplemented with red blood cells, which were a biological oxygen carrier. During the experiment (after 30h), perfusion fluid samples were taken, showing a clear difference in perfusion fluid oxygenation (
Also, tests were carried out on the bionic organ to evaluate its functionality, which, apart from the control of the basic parameters described above, also involved taking samples at set time points to assess insulin concentration after stimulation with glucose solutions of variable concentration (
A system used for cultivation of the bionic organ (
Temperature of the perfusion fluid was adjusted by means of heating-cooling circuits of the organ chamber 2 and the perfusion fluid container 1, a temperature sensor 30 of the organ chamber 2, a temperature sensor 31 of the perfusion fluid container 1, a control system and pumps 9 providing the flow of heating or cooling fluid. The organ chamber 2 had a heating-cooling circuit 13, allowing for flow of heating or cooling fluid.
For cultivation of the pig kidney of Example 1, a system was used that corresponded to that of Example 1, in which the perfusion fluid container 1 was not equipped with a swinging mechanism 16 and heating using Peltier modules 27. The container 1 was cylindrical in shape with ports located in its lower section (
List of references in drawings: 1-perfusion fluid container; 2-organ chamber; 3 means for measuring pH; 4-means for measuring glucose concentration; 5-oxygenator; 6-air bubble eliminator; 7-pressure sensor of perfusion fluid; 8-means for taking samples of perfusion fluid; 9-peristaltic pump; 10-container for medicaments and/or nutrients and/or perfusion fluid components; 11-heating-cooling plate; 12-heating-cooling circuit of an oxygenator; 13-heating-cooling circuit of an organ chamber; 14-means for measuring of loss of perfusion fluid; 15-rotating mechanism for rotating the organ chamber; 16-swinging mechanism of perfusion fluid container; 17-first line; 18-second line; 19-oxygenation/saturation sensor; 20-GUI processor; 21-real-time microprocessor; 22-TEC controller; 23-stepper motor controllers; 24-temperature measurement system; 25-glucose sensor; 26-liquid level sensor; 27-Peltier modules; 28-fans; 29-stepper motors; 30-temperature sensor of organ chamber; 31-temperature sensor of perfusion fluid container; 32-temperature sensor of oxygenator, 33-water jacket of perfusion fluid container of Example 3.
Number | Date | Country | Kind |
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20461600.7 | Dec 2020 | EP | regional |
Filing Document | Filing Date | Country | Kind |
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PCT/IB2021/062190 | 12/22/2021 | WO |