The present invention relates to a system for decellularizing blood vessels, as well as a process for decellularization.
As is described in U.S. Pat. No. 10,987,449, which is incorporated herein by reference in its entirety and for all purposes, to be successfully utilized for implantation, natural tissue (e.g., allograft and xenograft) is decellularized to remove the native cells and other potential immunogenic material and leave only the non-immunogenic structural materials (collagen, elastin, laminin, etc.).
Typical decellularization methods include a series of chemical (e.g., detergent or enzymatic) washes that can remove the cells by immersion.
While typical immersion methods can completely decellularize relatively thin and flat tissue samples, it can be more difficult to completely decellularize tubular body structures, such as veins and arteries, due to their tubular geometries. In view of the foregoing, described herein is a system and method for decellularizing tissue having tubular structures.
According to one aspect of the invention, a system for processing a tubular tissue sample defining a lumen and an exterior surface. The system includes a container having one or more walls defining a hollow interior chamber for receiving the tubular tissue sample. A first fluid inlet passage (e.g., 52a) is associated with the container and configured to direct fluid through the lumen of the tissue sample. A second fluid inlet passage (e.g., 52c) is also associated with the container and configured to direct fluid over the exterior surface of the tissue sample.
According to another aspect of the invention, a method for processing a tubular tissue sample that is stored in a container having one or more walls defining a hollow interior chamber, said method comprises:
According to yet another aspect of the invention, a tubular tissue product is produced by a process comprising:
The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention will be better understood by reference to the following description of an embodiment of the invention taken in conjunction with the accompanying drawings, wherein:
It is noted that the scaling throughout the figures may not be uniform.
Corresponding reference characters indicate corresponding parts throughout the several views. The exemplification set out herein illustrates an embodiment of the invention, in one form, and such exemplification is not to be construed as limiting the scope of the invention in any manner.
Inasmuch as various components and features of the system described herein are of well-known design, construction, and operation to those skilled in the art, the details of such components and their operations will not generally be discussed in significant detail unless considered of pertinence to the present invention or desirable for purposes of better understanding.
The fluid described herein used for decellularization may be any fluid known to those skilled in the art. As is described in U.S. Pat. No. 7,338,757, which is incorporated by reference herein in its entirety, the fluid may be an anionic agent, for example sodium dodecylsulfate (SDS).
In the drawings, like numerals refer to like items, certain elements and features may be labeled or marked on a representative basis without each like element or feature necessarily being individually shown, labeled, or marked, and certain elements are labeled and marked in only some, but not all, of the drawing figures.
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An inlet cap assembly 30 is mounted over inlet end 24 of tube 22. Similarly, an outlet cap assembly 32 is mounted over outlet end 26 of tube 22. A seal 33 (e.g., O-ring, face seal, piston rod seal, cylinder bore seal, etc.) is mounted between each cap assembly 30, 32 and its respective tube end 24 and 26, respectively, to prevent fluid from inadvertently escaping from tube 22. Each seal 33 may be positioned at least partially within a dove-tailed recess formed in the mounting surface of the respective cap assemblies 30, 32.
Each cap assembly 30, 32 includes a substantially circular plate having three flanges extending from a perimeter thereof. Each flange includes a hole that registers with a hole disposed on a hinge clamp assembly 34. Fasteners 36 are threaded through each set of registered holes for mounting the cap assembly 30, 32 to its respective hinge clamp assembly 34. Each hinge clamp assembly 34 comprises a two-part hinged structure that is clamped to an annular channel 35 formed on a respective end of tube 22. The individual parts of the two part hinged structure are fixed together by a fastener 38. It should be understood that clamp assemblies 34 are fixedly mounted to tube 22 once installed thereon. It should be understood that the invention is not limited to the details of the cap and clamp assemblies, as the mechanical interconnection between those components could vary greatly.
Turning now to the features of the inlet cap assembly 30, the inlet cap assembly 30 generally comprises a cap 50, fittings 44, seals for fittings 44, seal 33, fasteners 36, diffuser 72, seals 73, connectors 86 and 88, and seals for connectors 86.
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Two diametrically opposed tabs 55 (
Cap 50 includes a series of five fluid passages 52a-52e (referred to either individually or collectively as fluid passage(s) 52) passing therethrough. Each passage 52 is a hole or opening that passes through the entire thickness of cap 50.
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Inlet cap assembly 30 includes four connectors 86 and 88 for delivering fluid into the lumens of two grafts 21. More particularly, one hollow-chamber fluid flow connector 86 is connected to end 57a of one of the protuberances 54. An O-ring may be sandwiched between end 57a and connector 86 to prevent the inadvertent escape of fluid at that interface. A second connector 86 is connected to end 57a of the other protuberance 54. Each connector 86 includes a first connection end, which may be threaded, for connection to end 57a of protuberance 54, and a second connection end in the form of a female luer. A hollow chamber for transporting fluid is defined between the first and second connection ends of connector 86.
A hollow-chamber fluid flow connector 88 is connected to the second connection end of one of the connectors 86. Similarly, a hollow-chamber fluid flow connector 88 is connected to the second connection end of the other connector 86. Each connector 88 includes a first connection end, which may include a male luer, for connection to the second connection end of one of the connectors 86, and a second connection end in the form of a barb connector for direct connection to one of the grafts 21. A hollow chamber for transporting fluid is defined between the first and second connection ends of connector 88. Each connector 88 may be a female luer lock to barb connector, for example. It should be understood that the connectors 86 and 88 can vary and are not limited to that which is shown and described. Also, the mated connectors 86 and 88 could be combined into a single connector, if so desired. Furthermore, connectors 86 and 88 could be omitted in their entirety, if so desired, if end 57a of each protuberance were configured to be directly connected to a graft 21.
Turning now to the features of the outlet cap assembly 32 of the system 20, the outlet cap assembly 32 includes a cap 60, seal 33, fasteners 36, fitting 46, and a seal for fitting 46.
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In an assembled form of system 20, the openings 74 of diffuser 72 are seated against the shoulders 65 of protuberances 54 of cap 50. Seals 73 (
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In an assembled form of system 20, the tabs 84 of separator 80 are also positioned within respective slots 64 (
The components described herein may be formed from any materials known to those skilled in the art (plastic, metal, etc.), and formed using any process known to those skilled in the art (molding, casting, machining, etc.). The materials may be transparent, for example, for permitting an observer to visualize the decellularization process occurring within the system 20.
Turning now to one exemplary method of operating system 20, the system 20 is initially in a partially assembled state whereby inlet cap assembly 30 is pre-assembled and disconnected from tube 22 while outlet cap assembly 32 is connected to tube 22.
The grafts 21 are first connected to respective connectors 88. Specifically, a first graft 21 is connected to the barb connector of one of the connectors 88; and a second graft 21 is connected to the barb connection to the other connector 88. A suture or other device may optionally be used to aid in securing the grafts 21 to the connectors 88. The grafts 21 may (or may not) be laid on the surfaces of separator 80. Separator 80 is then positioned through the inlet end 24 of tube 22 until the tabs 84 of separator 80 are seated within slots 64 (
If not connected already, fluid delivery lines are connected to the inlet fittings 44a-44d. Fitting 44e may or may not be connected to an external line. Outlet fitting 46 may also be connected to a fluid egress line and/or storage vessel. The fluid egress line may be fluidly connected to the fluid delivery lines (by way of a pump for example) for recirculating the fluid back through system 20.
System 20 is then suspended vertically such that inlet cap assembly 30 is positioned at an elevation above outlet cap assembly 32. Grafts 21 are therefore suspended vertically by gravity. System 20 may or may not be enclosed within an incubator for heating the fluid within system 20.
Fluid is then delivered through the fittings 44a-44d. According to one embodiment, the same fluid is delivered through all of the fittings 44a-44d. Specifically, fluid delivered through fittings 44a and 44b is directed through passages 52a and 52b of protuberances 54, respectively, connectors 86 and 88 and into the lumens of grafts 21. The fluid migrates along the length of grafts 21 and also migrates through the walls of the grafts 21. The fluid is then expelled from the free ends 21a (
At the same time, fluid delivered through fittings 44c and 44d is distributed through the enlarged outlets 59b of passages 52c and 52d, respectively, and into the cylindrical space S (
Fluid in chamber 28 is expelled from system 20 via outlet cap assembly 32 and its outlet fitting 46. As noted above, a line may be connected to outlet fitting 46. Also, the expelled fluid may be recirculated back through the fittings 44a-44d of the inlet cap assembly 30.
It is noted that the foregoing method of operating the system 20 is not necessarily limited to any one of the steps or sequence of steps. Also, the system 20 could be modified to close various fittings 44 in order to process a different number or type of graft (i.e., non-tubular).
By virtue of its components parts, and as verified by computational fluid dynamics software and lab studies, the system 20 achieves a uniform flow and velocity profile along the entire length of the grafts 21. This is due at least in part to the cylindrical space S (
The diffuser 72 is downstream of the ports 59b to the chamber 28 and provides a partial blockage, causing a recirculation in order to diffuse the incoming jet of fluid from the smaller diameter external tubing being driven by the pump (not shown). It is desirable to have a more uniform velocity proceeding axially down the tube 20 where the grafts 21 are present. This could be accomplished with a long gradual expansion from the tubing inner diameter to the chamber tube inner diameter to avoid flow separation from the wall, but the diffuser 72 accomplishes a similar goal while saving space and reducing fluid volume.
The system 20 is configured to produce a range of pressure within the normal physiological range of the human circulatory system (˜30-180 mmHg) or as desired to achieve the endpoints of the process. However, the system 20 can be engineered to an arbitrarily high pressure capability, if so desired.
It is noted that the flow rates through each fitting 44a-44d may be maintained in a range of 90-120 mL/min, but could vary. According to one aspect, the ratio of solution volume to tissue volume may be greater than 10, for example. And, the operating temperature may be maintained at 0-50 degrees C., for example. To reach higher temperatures (such as 37 degrees C.), the system 20 may be stowed within an incubator.
The system 20 is intended for decellularization of vascular tissue, but could be used to decellularize other tissue types, rinse materials, stain materials, induce chemical reactions in materials, or other purposes that require a consistent flow along the length of the chamber. The system 20 is scalable in size, such that other diameters, lengths, volumes, and possibly shapes may be used. Due to the cost of materials and reagents, power required for heating and pumping fluid, and space constraints, the size and volume of system 20 has been minimized for cost and efficiency. According to one exemplary embodiment, there are four inlet ports and one outlet port, all with an internal diameter of 0.0938 in, with each inlet line being pumped at a speed of 80-115 mL/min (for example) with resulting fluid pressures between 0 and 180 mmHg. The flow rates and size and number of inlet ports may be adjusted, along with the size and number of outlet ports to achieve different pressures and velocities within the chamber. The fluid flow is created in this instance using peristaltic pumps, but can be induced by any pumping mechanism or, alternatively, by gravity. The fluid type, viscosity, and temperature may be any combination that results in a flowable liquid and may have dispersed particles flowing with the fluid.
One goal of tissue decellularization is to provide essentially an immunoprivilaged graft, similar to autologous tissue, through a thorough removal of cells and cell remnants while retaining the composition and structure of the extracellular matrix (ECM). Cryopreserved vascular allografts provide a surgeon with handling characteristics and hemodynamic profile similar to native tissue, however, due to maintenance of cell viability of the donor tissue, there have been instances where they have been shown to have a chronic graft rejection response. An inflammatory response may contribute to a loss of patency due to thrombosis and stenosis from neointimal hyperplasia. In addition, cryopreserved grafts have been shown to elicit a strong humoral immune response in various studies. These grafts can incite the development of anti-human leukocyte antigen class I and II antibodies that remain detectable years after implantation which might complicate future kidney transplantation. By eliminating major histocompatibility antigens, this response may be attenuated. These failure modes can still be present with a localized response due to insufficient decellularization, resulting in graft failure.
Therefore, one objective of the instant invention is to provide homogeneous and sufficient decellularization while maintaining the extracellular matrix and proteins along the entire length of the tube 22. This reduces the potential for an inflammatory and immune response and stenosis associated with cryopreserved and insufficiently decellularized allografts and provide an appropriate environment for repopulation of native cells in the recipient. Additionally, the invention seeks to maintain the appropriate hemodynamic profile throughout the tube 22 to ensure long-term patency in an AV Access graft.
The system design was evaluated along the length of the tube 20. The evaluation focused on the following criteria:
A. H&E-stained sections revealed the presence of cells repopulating the graft that fully infiltrated the tunica adventitia (TA) and approximately one-half of the tunica media (TM).
B. Cellular infiltrate stained positive for proliferating nuclear cell antigen (PCNA), an intracellular protein that indicates cell replication, and thus, cell viability.
C. A TUNEL assay, which detects DNA fragments occurring during apoptotic cells, or programmed cell death, revealed few positive-stained cells in the graft, further supporting that the cells repopulating the graft were viable.
D. Cells in the graft stained positive for aSMA and HSP47 indicating the cells repopulating the graft expressed proteins that are typical of native cells. Specifically, aSMA is expressed by smooth muscle cells, the predominant cell type of the vascular wall, and HSP47 is a marker for collagens I and III production, the predominant collagen types of the vascular wall.
E. A mild inflammatory infiltrate was also observed, both in the TM and the TA. Altogether, the relatively mild inflammatory response coupled with the effective recellularization, with viable and phenotypically correct cells required for remodeling and healing, demonstrate good biocompatibility of the graft.
F. Movat's staining revealed connective tissue and recipient cells within the TA extending into the TM, and variably into the tunica intima (TI), both at the carotid and jugular anastomoses and in mid-graft sections. Within the TA, organized connective tissue primarily composed of collagen was detected, while in the TM and TI, proteoglycans and αSMA-positive cells were seen. A mild foreign body inflammatory response associated with suture fragments was also noted, which is an expected finding after implantation. The presence of these matrix components and aSMA-positive cells, essential building blocks of the vascular wall, indicate evidence of healing in the grafts.
While this invention has been described with respect to at least one embodiment, the present invention can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains and which fall within the limits of the appended claims.
This application claims priority from U.S. Provisional Application Ser. No. 63/298,780, titled “SYSTEM AND PROCESS FOR DECELLULARIZING BLOOD VESSELS,” filed Jan. 12, 2022, incorporated herein by reference in its entirety for all purposes.
Filing Document | Filing Date | Country | Kind |
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PCT/US2023/010553 | 1/11/2023 | WO |
Number | Date | Country | |
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63298780 | Jan 2022 | US |