Fetal Tissue Engineered Patches to Repair Congenital Anomalies
Inventors: Dario Fauza
SubCategories: Regenerative Medicine, Stem Cell, Surgery/Wound Healing
Dario Fauza, MD, associate in Surgery, has pioneered fetal tissue engineering by producing tissue to repair congenital anomalies. He has developed a method to harvest and purify fetal cells from the amniotic fluid surrounding a fetus in utero. Some amniotic cells have stem cell like pluripotency and can differentiate into different tissue types. Dr. Fauza combined these cells with scaffolding materials to engineer new tissues for successful surgical reconstruction in large animals (sheep). He is planning clinical trials in newborn patients with different prenatally diagnosed birth defects, initially focusing on Congenital diaphragmatic hernia (CDH).
Dr. Fauza has had success in building and implanting an engineered diaphragm, trachea, and bone in sheep. Because these grafts are made using the recipientâ€™s own fetal cells that have been shed into the amniotic fluid, there would be no risk of the immune system rejecting the grafts. Further, these engineered constructs are generated in parallel to gestation, so they can be available for surgical reconstruction immediately at birth, or even prenatally, enhancing the repair of congenital anomalies that need prompt reconstructive treatment.
Major congenital anomalies occur in 3-4% of all live births in the United States and treatments currently available for many of these anamalies remain suboptimal. CDH is among the most common major structural congenital anomalies, occurring in approximately 1:2,200 births. Most pediatric surgeons currently use a prosthesis made of expanded Teflon and post-operative hernia recurrence rates have been reported to be as high as 50% or more. The main failure mechanism is thought to be related to normal growth of the recipient, leading to traction of the patch and eventual detachment of the prosthesis. Repair with artificial prosthetic patches has also been associated with higher rates of infection, adhesions and both thoracic and spinal column deformities. Dr. Fauza has shown that tissue engineered diaphragmatic patch survives and remodels as the animal grows. While the repair of CDH with this methodology is closer to clinical reality, subsequent comparable clinical developments involving other congenital anomalies are expected.
Key Publications: J Pediatr Surg. 2007 Jun;42(6):974-980