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Levvey BJ, Snell GI. How do we expand the lung donor pool? Curr Opin Pulm Med 2024; 30:398-404. [PMID: 38546199 DOI: 10.1097/mcp.0000000000001076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
PURPOSE OF REVIEW Lung transplantation activity continues to be limited by the availability of timely quality donor lungs. It is apparent though that progress has been made. The steady evolution of clinical practice, combined with painstaking scientific discovery and innovation are described. RECENT FINDINGS There have been successful studies reporting innovations in the wider use and broader consideration of donation after circulatory death donor lungs, including an increasing number of transplants from each of the controlled, uncontrolled and medically assisted dying donor descriptive categories. Donors beyond age 70 years are providing better than expected long-term outcomes. Hepatitis C PCR positive donor lungs can be safely used if treated postoperatively with appropriate antivirals. Donor lung perfusion at a constant 10 degrees appears capable of significantly improving donor logistics and ex-vivo lung perfusion offers the potential of an ever-increasing number of novel donor management roles. Bioartificial and xenografts remain distant possibilities only at present. SUMMARY Donor lungs have proved to be surprisingly robust and combined with clinical, scientific and engineering innovations, the realizable lung donor pool is proving to be larger than previously thought.
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Affiliation(s)
- Bronwyn J Levvey
- Lung Transplant Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, and Monash University, Melbourne, Australia
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Moura RS, Afonso JPR, Fonseca AL, Cereta AD, Mello DACPG, Oliveira MC, Oliveira-Silva I, Oliveira RF, Oliveira DAAP, Vieira RP, Palma RK, Insalaco G, Oliveira LVF. Extracellular matrix of lung scaffolds submitted to different means of sterilization: a systematic review. F1000Res 2024; 13:554. [PMID: 39155967 PMCID: PMC11329863 DOI: 10.12688/f1000research.147670.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 08/20/2024] Open
Abstract
Chronic respiratory diseases often necessitate lung transplantation due to irreversible damage. Organ engineering offers hope through stem cell-based organ generation. However, the crucial sterilization step in scaffold preparation poses challenges. This study conducted a systematic review of studies that analysed the extracellular matrix (ECM) conditions of decellularised lungs subjected to different sterilisation processes. A search was performed for articles published in the PubMed, Web of Sciences, Scopus, and SciELO databases according to the PRISMA guidelines. Overall, five articles that presented positive results regarding the effectiveness of the sterilisation process were selected, some of which identified functional damage in the ECM. Was possible concluded that regardless of the type of agent used, physical or chemical, all of them demonstrated that sterilisation somehow harms the ECM. An ideal protocol has not been found to be fully effective in the sterilisation of pulmonary scaffolds for use in tissue and/or organ engineering.
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Affiliation(s)
- Ricardo S. Moura
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Joao Pedro R. Afonso
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Adriano L. Fonseca
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Andressa D. Cereta
- Departament of Surgery, Faculty of Veterinary Medicine and Animal Science - University of São Paulo, São Paulo, São Paulo, Brazil
| | - Diego A. C. P. G. Mello
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Miria C. Oliveira
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Iransé Oliveira-Silva
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Rodrigo F. Oliveira
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Deise A. A. P. Oliveira
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Rodolfo P. Vieira
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
| | - Renata K. Palma
- Cell Culture Laboratory, Evangelical University of Goiás - UniEVANGELICA, Anapolis, Goias, 75075-580, Brazil
- Facultad de Ciencias de la Salud de Manresa, Universitat de Vic-Universitat Central de Catalunya - UVic-UCC, Manresa, Spain
| | - Giuseppe Insalaco
- Institute of Translational Pharmacology, National Research Council - CNR, Palermo, SI, Italy
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Tomiyama F, Suzuki T, Watanabe T, Miyanaga J, Suzuki A, Ito T, Murai S, Suzuki Y, Niikawa H, Oishi H, Notsuda H, Watanabe Y, Hirama T, Onodera K, Togo T, Noda M, Waddell TK, Karoubi G, Okada Y. Orthotopic transplantation of the bioengineered lung using a mouse-scale perfusion-based bioreactor and human primary endothelial cells. Sci Rep 2024; 14:7040. [PMID: 38575597 PMCID: PMC10994903 DOI: 10.1038/s41598-024-57084-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/14/2024] [Indexed: 04/06/2024] Open
Abstract
Whole lung engineering and the transplantation of its products is an ambitious goal and ultimately a viable solution for alleviating the donor-shortage crisis for lung transplants. There are several limitations currently impeding progress in the field with a major obstacle being efficient revascularization of decellularized scaffolds, which requires an extremely large number of cells when using larger pre-clinical animal models. Here, we developed a simple but effective experimental pulmonary bioengineering platform by utilizing the lung as a scaffold. Revascularization of pulmonary vasculature using human umbilical cord vein endothelial cells was feasible using a novel in-house developed perfusion-based bioreactor. The endothelial lumens formed in the peripheral alveolar area were confirmed using a transmission electron microscope. The quality of engineered lung vasculature was evaluated using box-counting analysis of histological images. The engineered mouse lungs were successfully transplanted into the orthotopic thoracic cavity. The engineered vasculature in the lung scaffold showed blood perfusion after transplantation without significant hemorrhage. The mouse-based lung bioengineering system can be utilized as an efficient ex-vivo screening platform for lung tissue engineering.
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Affiliation(s)
- Fumiko Tomiyama
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Takaya Suzuki
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, 101 College Street, Toronto, ON, M5G1L7, Canada.
| | - Tatsuaki Watanabe
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Jun Miyanaga
- Institute of Fluid Science, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi, 980-8577, Japan
| | - Anna Suzuki
- Institute of Fluid Science, Tohoku University, 2-1-1 Katahira, Aoba-ku, Sendai, Miyagi, 980-8577, Japan
| | - Takayasu Ito
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Sho Murai
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yuyo Suzuki
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Hiromichi Niikawa
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Hisashi Oishi
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Hirotsugu Notsuda
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Yui Watanabe
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Takashi Hirama
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Ken Onodera
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Takeo Togo
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Masafumi Noda
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Thomas K Waddell
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, 101 College Street, Toronto, ON, M5G1L7, Canada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S1A8, Canada
| | - Golnaz Karoubi
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, 101 College Street, Toronto, ON, M5G1L7, Canada
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, M5S1A8, Canada
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Petpiroon N, Netkueakul W, Sukrak K, Wang C, Liang Y, Wang M, Liu Y, Li Q, Kamran R, Naruse K, Aueviriyavit S, Takahashi K. Development of lung tissue models and their applications. Life Sci 2023; 334:122208. [PMID: 37884207 DOI: 10.1016/j.lfs.2023.122208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/04/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
The lungs are important organs that play a critical role in the development of specific diseases, as well as responding to the effects of drugs, chemicals, and environmental pollutants. Due to the ethical concerns around animal testing, alternative methods have been sought which are more time-effective, do not pose ethical issues for animals, do not involve species differences, and provide easy investigation of the pathobiology of lung diseases. Several national and international organizations are working to accelerate the development and implementation of structurally and functionally complex tissue models as alternatives to animal testing, particularly for the lung. Unfortunately, to date, there is no lung tissue model that has been accepted by regulatory agencies for use in inhalation toxicology. This review discusses the challenges involved in developing a relevant lung tissue model derived from human cells such as cell lines, primary cells, and pluripotent stem cells. It also introduces examples of two-dimensional (2D) air-liquid interface and monocultured and co-cultured three-dimensional (3D) culture techniques, particularly organoid culture and 3D bioprinting. Furthermore, it reviews development of the lung-on-a-chip model to mimic the microenvironment and physiological performance. The applications of lung tissue models in various studies, especially disease modeling, viral respiratory infection, and environmental toxicology will be also introduced. The development of a relevant lung tissue model is extremely important for standardizing and validation the in vitro models for inhalation toxicity and other studies in the future.
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Affiliation(s)
- Nalinrat Petpiroon
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), 111 Thailand Science Park, Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
| | - Woranan Netkueakul
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), 111 Thailand Science Park, Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand
| | - Kanokwan Sukrak
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), 111 Thailand Science Park, Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand; Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand; Thailand Network Center on Air Quality Management: TAQM, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chen Wang
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan
| | - Yin Liang
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan
| | - Mengxue Wang
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan
| | - Yun Liu
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan
| | - Qiang Li
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan
| | - Rumaisa Kamran
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan
| | - Keiji Naruse
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan
| | - Sasitorn Aueviriyavit
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), 111 Thailand Science Park, Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand.
| | - Ken Takahashi
- Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ward, Okayama 700-8558, Japan.
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Abraham AS, Singh M, Abraham MS, Ahuja S. Epidemiology and Long-Term Outcomes in Thoracic Transplantation. J Cardiovasc Dev Dis 2023; 10:397. [PMID: 37754826 PMCID: PMC10531612 DOI: 10.3390/jcdd10090397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/19/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
Over the past five decades, outcomes for lung transplantation have significantly improved in the early post-operative period, such that lung transplant is now the gold standard treatment for end-stage respiratory disease. The major limitation that impacts lung transplant survival rates is the development of chronic lung allograft dysfunction (CLAD). CLAD affects around 50% of lung transplant recipients within five years of transplantation. We must also consider other factors impacting the survival rate such as the surgical technique (single versus double lung transplant), along with donor and recipient characteristics. The future is promising, with more research looking into ex vivo lung perfusion (EVLP) and bioengineered lungs, with the hope of increasing the donor pool and decreasing the risk of graft rejection.
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Affiliation(s)
- Abey S. Abraham
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA; (A.S.A.); (M.S.)
| | - Manila Singh
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA; (A.S.A.); (M.S.)
| | | | - Sanchit Ahuja
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA; (A.S.A.); (M.S.)
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Ding Z, Tang N, Huang J, Cao X, Wu S. Global hotspots and emerging trends in 3D bioprinting research. Front Bioeng Biotechnol 2023; 11:1169893. [PMID: 37304138 PMCID: PMC10248473 DOI: 10.3389/fbioe.2023.1169893] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Three-dimensional (3D) bioprinting is an advanced tissue engineering technique that has received a lot of interest in the past years. We aimed to highlight the characteristics of articles on 3D bioprinting, especially in terms of research hotspots and focus. Publications related to 3D bioprinting from 2007 to 2022 were acquired from the Web of Science Core Collection database. We have used VOSviewer, CiteSpace, and R-bibliometrix to perform various analyses on 3,327 published articles. The number of annual publications is increasing globally, a trend expected to continue. The United States and China were the most productive countries with the closest cooperation and the most research and development investment funds in this field. Harvard Medical School and Tsinghua University are the top-ranked institutions in the United States and China, respectively. Dr. Anthony Atala and Dr. Ali Khademhosseini, the most productive researchers in 3D bioprinting, may provide cooperation opportunities for interested researchers. Tissue Engineering Part A contributed the largest publication number, while Frontiers in Bioengineering and Biotechnology was the most attractive journal with the most potential. As for the keywords in 3D bioprinting, Bio-ink, Hydrogels (especially GelMA and Gelatin), Scaffold (especially decellularized extracellular matrix), extrusion-based bioprinting, tissue engineering, and in vitro models (organoids particularly) are research hotspots analyzed in the current study. Specifically, the research topics "new bio-ink investigation," "modification of extrusion-based bioprinting for cell viability and vascularization," "application of 3D bioprinting in organoids and in vitro model" and "research in personalized and regenerative medicine" were predicted to be hotspots for future research.
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Affiliation(s)
- Zhiyu Ding
- Department of Orthopaedics, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
| | - Ning Tang
- Department of Orthopaedics, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Junjie Huang
- Department of Orthopaedics, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
| | - Xu Cao
- Department of Orthopaedics, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China
| | - Song Wu
- Department of Orthopaedics, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
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