Aus der Klinik
für Herz-, Thorax- und Gefäßchirurgie des Deutschen Herzzentrums Berlin
der Medizinischen Fakultaet Charité
der Humboldt- Universitaet zu Berlin
Berlin, Germany

und

aus dem
Texas Heart Institute at St. Luke's Episcopal Hospital/
The University of Texas Health Science Center at Houston
Texas, USA

DISSERTATION

Use of Autologous Auricular Chondrocytes
For Lining Left Ventricular Assist Devices

Zur Erlangung des akademischen Grades
Doctor medicinae (Dr. med.)

Vorgelegt der Medizinischen Fakultaet Charité
der Humboldt- Universitaet zu Berlin

von

Doreen Rosenstrauch


aus Zossen


[page 2↓]

Dekan: Prof. Dr. Joachim W. Dudenhausen

Gutachter:
1. Prof. Dr.med. Hans H. Scheld
2. PD Dr.med. Michael Settinger
3. Prof. Dr.med. Roland Hetzer

Datum der Promotion: 23. April 2004


[page 28↓]

ABSTRACT

Background: Auricular elastic cartilage is a potential source of autologous cells for lining the luminal surfaces of left ventricular assist devices (LVAD’s) to improve long-term biocompatibility. We evaluated this potential in vitro and in vivo in a calf model.

Methods: In vitro, auricular cartilage was harvested from the anesthetized ear of a calf, isolated, and cultured on tissue culture dishes. Primary chondrocytes were typed by immunocytochemistry, transferred into culture media, passaged twice, and seeded onto the blood-contacting luminal surfaces of four LVAD’s (HeartMate®; Thermo Cardiosystems, Inc., Woburn, MA). The seeded cell linings were preconditioned under flow conditions in vitro to promote cell adhesion to the luminal surfaces. Seeding efficiency and cumulative cell loss under flow conditions in vitro were quantitated. In vivo, one of the four preconditioned, autologous chondrocyte-lined LVAD’s was implanted into the tissue-donor calf; run for 7 days; explanted; and finally evaluated grossly, by scanning electron microscopy, and by transmission electron microscopy.

Results: Autologous chondrocytes were seeded onto the luminal surfaces of the four LVAD’s. The seeding efficiency was 95.11± 4.23% (n = 4). Cumulative cell loss during preconditioning under flow conditions in vitro did not exceed 12% (n = 4). After 7 days of in vivo implantation, the luminal surfaces of the implanted LVAD demonstrated an intact, strongly adherent cellular lining. There was no evidence of thromboembolic events at necropsy.


[page 29↓]

Conclusions: Auricular elastic cartilage is a ready and easily accessible source of chondrocytes whose ability to produce collagen II and other important extracellular matrix constituents allows them to adhere strongly to the luminal surfaces of LVAD’s. The simple method of isolating and expanding auricular chondrocytes presented here could be used to provide autologous cell linings for LVAD’s and other cardiovascular devices to improve their long-term biocompatibility. Our successful short-term feasibility study in a calf model warrants further study in vivo.

Keywords: auricular, chondrocytes, tissue engineering, left ventricular assist device, elastic cartilage

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