| Project/Area Number |
17390387
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Tokyo Women's Medical University |
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Principal Investigator |
YAMAMOTO Noboru (2007) Tokyo Women's Medical University, School of Medicine, Assistant professor (50297470)
新岡 俊治 (2005-2006) 東京女子医科大学, 医学研究科, 教授 (20192122)
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| Co-Investigator(Kenkyū-buntansha) |
KUROSAWA Hiromi Tokyo Women's Medical University, School of Medicine, professor (50075511)
MATSUMURA Goki Tokyo Women's Medical University, School of Medicine, Assistant professor (20297469)
石山 雅邦 東京女子医科大学, 医学部, 助手 (30246558)
山本 昇 東京女子医科大学, 医学部, 助手 (50297470)
小坂 由道 東京女子医科大学, 医学部, 助手 (90297507)
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| Project Period (FY) |
2005 – 2007
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| Project Status |
Completed (Fiscal Year 2007)
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| Budget Amount *help |
¥15,150,000 (Direct Cost: ¥13,800,000、Indirect Cost: ¥1,350,000)
Fiscal Year 2007: ¥5,850,000 (Direct Cost: ¥4,500,000、Indirect Cost: ¥1,350,000)
Fiscal Year 2006: ¥4,500,000 (Direct Cost: ¥4,500,000)
Fiscal Year 2005: ¥4,800,000 (Direct Cost: ¥4,800,000)
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| Keywords | Tissue Engineering / Vessels / Biodegradable Scaffold / Surgery / Clinical Application / Evaluation / Congenital Heart Disease / 生力学試験 / 生体吸収性ポリマー / 臨床応用 / フォンタン手術 / 中期遠隔成績 / 自己骨髄細胞 / 再生弁 |
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| Research Abstract |
Prosthetic and bioprosthetic materials currently in use lack growth potential and therefore must be repeatedly replaced in pediatric cardiovascular patients as they grow. Tissue engineering is a new discipline that offers the potential for creating replacement structures from autologous cells and biodegradable scaffolds. In May 2000, we initiated clinical application of tissue-engineered vascular autografts (TEVAs) seeded with cultured cells. However, cell culturing is time-consuming, and xenoserum must be used. To overcome these disadvantages, we began to use bone marrow cells, readily available on the day of surgery, as a cell source.
Since September 2001, 44 patients had a cardiothoracic operation using TEVAs seeded with autologous bone marrow cells. Three to 10 mL/kg specimen of bone marrow was aspirated with the patient under general anesthesia before the skin incision. These cells were seeded onto the absorbable scaffold before implantation. This scaffold was composed of a copolym
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er of P (CL/LA) which degrades by hydrolysis. PLLA or PGA woven fabric were used for reinforcement of the scaffolds. Twenty-six tissue-engineered conduits and 19 tissue-engineered patches were used for the repair of congenital heart defects. Patients who had undergone this method had a catheterization study, CT scan, or both for the evaluation after the operation. Four late deaths due to the heart failure with or without multiple organ failure or brain bleeding in this series; these were unrelated to the TEVAs function. A few patient required PTA for the tubular graft-stenosis with pressure gradient and / or collaterals, and four patients for the stenosis of the tissue-engineered patch. However, this tissue-engineering approach may provide an important alternative to the use of prosthetic materials in the field of pediatric cardiovascular surgery. As it utilizes living autologous living tissue, this newly developed vascular structure may have the potential to achieve "auto-tissue repair" for the children with congenital heart defects. However, this approach is still in its infancy, further experimental studies to resolve the problems presented, and longer follow-up in patients are necessary to confirm the durability of this approach. Less
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