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(Circulation Research. 2006;99:e10.)
© 2006 American Heart Association, Inc.

Letters to the Editor

Results With Decellularized Xenografts

Pascal M. Dohmen, Wolfgang Konertz

Department of Cardiovascular Surgery, Charite Hospital, Medical University Berlin, Germany

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

We have read the review article by Vesely¹ regarding heart valve tissue engineering with great attention. The Vesely article describes recent state-of-the-art approaches to the creation of an optimal heart valve prosthesis. We feel, however, that some additional information needs to be added, as the reader could be misled by some statements made in the Vesely article.

The development of decellularized xenogenic scaffolds began in 1984, which is correctly stated by the author. Several enzymes and detergents have been investigated to eliminate interstitial cells. The author describes different techniques for decellularization and correctly concludes that most of these treatments are ineffective. Leyh et al² showed the effective elimination of endothelial and interstitial cells. This method, however, interferes with the extracellular matrix and results in severe structural degeneration and hemodynamic instability of the decellularized tissue in the sheep model. Simon et al³ showed in a clinical study the ineffectiveness of a complex treatment—the "SynerGraft technology"—by using a combination of enzymes (DNAase and RNAase), detergents, cryopreservation, and radiation. Early results showed catastrophic failures of these decellularized xenogenic heart valves. This valve was subsequently eliminated from the market. This method of decellularization seems to be aggressive, and not only eliminates cells, but also destroys extracellular matrix structures, resulting in structural deterioration as well as early calcification. Consequently, decellularization of xenogenic heart valves, according to the "SynerGraft technology" should be avoided.

We reported the experimental results of a different decellularization technique, based on deoxycholic acid, which was not mentioned in the . . . [Full Text of this Article]