current advacnces in heart transplant

8/13/2019 Current Advacnces in Heart Transplant

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CURRENTADVANCESINHEART

TRANSPLANT

by Mirajini Manoharan


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CONTENT

Introduction

Mechanically Assisted Devices

What is it?

How does it work?

Who is it used for?

Limitations

Stem Cells

Extra cellular Matrix

Decellularization

Recellularization


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INTRODUCTION

Heart transplants:

An allograft is the only definitive treatment for end-

stage heart failure

But: Shortage of organs

Currently, fewer than 3000 donor hearts per year are

available worldwide

vs.

An estimated 12 million new annual diagnoses of heart

failure


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MECHANICALLYASSISTEDDEVICES


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WHATISIT?

o Not an Artificial Heart

o Assist the ventricles in pumping blood to

successfully restore the patients blood flow

o

Reduce the work load of the ventricleso Relieve symptoms of heart failure

o 2 types:

o Left ventricular assisted device (LVAD)

o Right ventricular assisted device (RVAD)


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HOWDOESITWORK?


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WHATISITUSEDFOR?

1. Bridge to transplant

2. Bridge to recovery

3. Destination therapy


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LIMITATIONS

Infection

Thrombus formation

Mechanical breakdown

Right sided heart failure


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STEMCELLS


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STEMCELLS

Cell therapy

Whole organ engineering


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WHOLEORGANENGINEERING

Extracellular Matrix

Decellularization

Recellularization


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EXTRACELLULARMATRIX(ECM)

Consist of protein that are secreted by the cells

These ECM proteins are site specific

Guides organ development, repair and physiologic

regeneration

In cell engineering these proteins provide footprint

of the previous resident cells .


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DECELLULARIZATION


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RECELLULARIZATION


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SUMMARY

Introduction

Mechanically Assisted Devices

What is it?

How does it work?

Who is it used for?

Limitations

Stem Cells

Extra cellular Matrix

Decellularisation

Recellularisation


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QUESTIONS?


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REFERENCES

Kirklin J.K., Naftel D.C., Kormos R.L., Stevenson L.W., Pagani

F.D., Miller M.A. et al. The Fourth INTERMACS Annual Report:

4000 implants and counting. The journal of Heart and Lung

Transplantation2012 Feb; 31: 117-126

Rose E.A., Geljins A.c., Moskowitz A.J., Heitjan D.F., Stevenson

L.W., Dembitsky W. et al. Long- Term use of Left Ventricular Assist

Device for end- stage heart failure. N Engl J Med 2001; 345: 1435-

1443

Maddox T.M., Heart Disease and Left Ventricular Assist Device

(LVAD) [internet]. 2012[updated 2012 Feb 22; cited 2012 Mar 20]

available from: http://www.nhlbi.nih.gov/health/health-

topics/topics/vad/

What is a Ventricular Assist Device [internet] 2012 [ updated 2009

Sep; cited 2012 March 20] available from:

http://www.webmd.com/heart-disease/treating-left-ventricular-

device
http://www.nhlbi.nih.gov/health/health-topics/topics/vad/http://www.nhlbi.nih.gov/health/health-topics/topics/vad/http://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.webmd.com/heart-disease/treating-left-ventricular-devicehttp://www.nhlbi.nih.gov/health/health-topics/topics/vad/http://www.nhlbi.nih.gov/health/health-topics/topics/vad/http://www.nhlbi.nih.gov/health/health-topics/topics/vad/


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REFERENCES(2)

New York Presbyterian. Artificial Heart- Ventricular Assist Devices(VADs) [internet] 2012 [cited 2012 Mar 20] available from:http://nyp.org/services/ctsurg/vads.html

Crapo M. P., Gilbert W. T., Badylak F. S.. An overview of tissue andwhole organ decellularization processes. Biomaterials - 2011; 32:

3233- 3243 Stubbs L.S, Crook J.M., Wayne A.M., FRACSa.b, Newcomb A.E.,

FRACSb.c. Toward Clinical Application of Stem Cells for CardiacRegeneration. Heart, Lung and Circulation2011; 20:173-179

Ott H.C., Matthiesen T.S., Goh S., Black L.D., Kren S.M., Netoff

T.I., Taylor D.A..Perfusion-decellularized matrix: using naturesplatform to engineer a bioartificial heart.Nature Medicine2008Feb; 14: 213- 221

Iyer R.K., Chiu L. LY., Reis L.A., Radisic M.. Engineered cardiactissues. Current Opinion in Biotechnology2011; 22: 706- 714
http://nyp.org/services/ctsurg/vads.htmlhttp://nyp.org/services/ctsurg/vads.html


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REFERENCES(3)

Makkar R.M., Smith R.R., Cheng K., Malliaras K., Thomson L.E.J.,

Berman D., Czer L.S.C., Marbn L., Mendizabal A., Johnston P.V.,

Russell S.D., Schuleri K.H., Lardo A.L., Gerstenblith G., Marbn E..

Intracoronary cardiosphere-derived cells for heart regeneration after

myocardial infarction (CADUCEUS): a prospective, randomised

phase 1 trial. Lancet2012; 379- 895- 904

Taylor D.A.. From stem cells and cadaveric matrix to engineered

organs. Current Opinion in Biotechnology2009; 20: 598- 605

Song J.J., Ott H.C.. Organ engineering based on decellularized

matrix scaffolds. Trends in Molecular Medicine2011 Aug; 17:

424- 432

Ilic D., Polak J., Stem cell based therapywhere are we going.

Lancet2012 Mar; 379; 877- 878

current advacnces in heart transplant

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