Editors' ChoiceTissue Engineering

Fabricating a new heart: One step closer to reality

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Science Translational Medicine  01 May 2019:
Vol. 11, Issue 490, eaax4870
DOI: 10.1126/scitranslmed.aax4870


Cardiomyocytes and endothelial cells printed in omentum-derived hydrogels generate perfusable thick heart tissue that can be implanted in rodents.

For patients suffering from cardiovascular diseases, there is a hope that someday a failing heart could be replaced by a new heart, regenerated with the patient’s own cells. Fabricating a new heart is a formidable task that faces many technological hurdles. Challenges include the need for heart-associated cells that match the patient’s immunological profile and methods to make the cells produce various proteins and cytokines necessary to generate and maintain heart tissue. Thanks to the remarkable work from Noor et al., this hope has recently become closer to reality.

A comprehensive strategy is required to assemble billions of cells and tissue fragments into a complex, three-dimensional (3D), and anatomically correct structure that is capable of performing the heart’s mechanical functions. Noor et al. reprogrammed cells from patient omental tissue into pluripotent stem cells and subsequently differentiated the pluripotent cells into cardiomyocytes and endothelial cells. Using decellularized omental tissues, the authors synthesized polymers that could solidify into hydrogels that support 3D printing. Using a state-of-the-art 3D printer and the above hydrogels as cell carriers, the authors patterned cardiomyocytes and endothelial cells into structures that resembled thick heart tissues including networks of blood vessels and cardiac muscle. To evaluate the potential use of these structures for replacement cardiac tissue, a rat omental implantation model was used. As a proof of concept, the same technology was applied to fabricate a miniaturized human heart (~14 mm in diameter) containing cardiac vessels and ventricles that supported the flow of media.

Although there are remaining technological gaps to overcome—including the challenge of producing pluripotent cells in a clinically relevant number—this work represents a milestone toward the ultimate goal of engineering a beating heart. In addition to heart replacement, the reported technology may be applied to engineering other organs of patient-specific cellular, tissue, and anatomical properties.

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