| Popis: |
The pericardium is a biological tissue widely used as a biomaterial for tissue engineering applications, including the construction of a variety of bioprostheses such as vascular grafts, patches for abdominal or vaginal wall reparation and, more frequently, heart valves. However, despite significant advances, some drawbacks have been found in these bioprostheses such as biological matrix deterioration and tissue degeneration associated with calcifications, even though xenopericardium or glutaraldehyde-treated autologous pericardium were used. In non-autologous pericardial processing, the pericardium must be decellularized in order to remove cellular antigens and procalcific remnants while preserving extracellular matrix integrity. A large variety of decellularization protocols exist, such as chemical, physical or enzymatic methods. Additional cross-linking processing must be carried out to render the tissue non-antigenic and mechanically strong. So far, almost all bioprosthetic materials made of pericardium, and used in clinical practice, are glutaraldehyde-treated bovine or porcine xenopericardium. However, long-term reports are raising issues concerning their durability, especially highlighting the high risk of calcification. Regarding heart valves, calcification currently represents the major drawback leading to potential failure of the bioprosthesis. The aim of this review is to present current issues, challenges, outcomes and future prospects of pericardial processing, including decellularization and cross-linking steps. Understanding current issues and improving pericardial processing will allow refining bioprosthesis conception and patients’ safety. |
