Regenerative Therapy

Regenerative Therapy

Volume 15, December 2020, Pages 258-264
Regenerative Therapy

Original Article
Novel device prototyping for endoscopic cell sheet transplantation using a three-dimensional printed simulator

https://doi.org/10.1016/j.reth.2020.10.007Get rights and content
Under a Creative Commons license
open access

Highlights

  • We invented a novel device for endoscopic cell sheet transplantation.

  • We optimized the transplantation procedure using three-dimensional printed simulator.

  • Commercialization of the device may provide standardized cardiac regenerative therapy.

Abstract

Introduction

Considering higher risks of candidates for cardiac regenerative therapy with compromised cardiac function, it is anticipated to develop less invasive surgical procedures. In the present study, we aimed to develop a prototype of totally endoscopic cell sheet delivery device and evaluate the surgical technique for epicardial cell sheet placement using three-dimensional (3D) printed simulators based on human computed tomography data.

Methods

We designed an endoscopic cell sheet delivery device with outer and inner frame with self-expandable applicator which can be opened in thoracic cavity. We launched spout line to provide liquids on the applicator surface and tension line to gently bend the applicator dorsally. We prepared human mesenchymal stem cell (MSC) sheets and compared wet/dry conditions of 3D printed heart/porcine heart and applicator to identify suitable conditions for cell sheet transplantation. Finally we validated the feasibility of endoscopic transplantation to anterior and lateral wall of left ventricle using 3D printed simulators.

Results

Moist condition of both 3D printed heart/porcine heart surface and applicator at transplantation yielded highest successful rate (100%, p = 0.0197). For both endoscopic transplantation sites, MSC sheets were successfully deployed. The procedure duration was 157 ± 23 s for anterior wall and 123 ± 13 s for the lateral wall in average, respectively.

Conclusions

We developed a novel prototype of endoscopic cell sheet delivery device for minimally-invasive cardiac regenerative therapy utilizing a 3D printed simulator. The commercialization of the prototype may provide a safe minimally-invasive method to deliver potential cardiac regenerative therapy in the future.

Keywords

Cardiac regenerative medicine
Cell sheet
Cell therapy
Minimally-invasive surgery
Simulator study

Abbreviations

3D
three dimensional
MSC
mesenchymal stem cell
TERT
telomerase reverse transcriptase
αMEM
alpha minimum essential medium
FBS
fetal bovine serum
EDTA
ethylenediaminetetraacetic acid
ECSheeD
endoscopic cell sheet delivery device
CT
computed tomography
LV
left ventricle

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Peer review under responsibility of the Japanese Society for Regenerative Medicine.