Use of bioengineered human acellular vessels to treat traumatic injuries in the Ukraine–Russia conflict

Sokolov, Oleksandr and Shaprynskyi, Vasyl and Skupyy, Oleh and Stanko, Oleksandr and Yurets, Serhii and Yurkova, Yuliya and Niklason, Laura E (2023) Use of bioengineered human acellular vessels to treat traumatic injuries in the Ukraine–Russia conflict. The Lancet Regional Health - Europe, Vol.29. p. 100650. ISSN 2666-7762

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Abstract

On February 24th 2022, the Russian Federation invaded Ukraine. Consistent with other modern conflicts, blastsand shrapnel penetration have caused a large fraction ofthe traumatic injuries, creating contaminated woundsthat often compromise the vascular supply to limbs andorgans. Although autogenous veins are the preferredoption for repair, their limited availability leads to the useof synthetic grafts. However, usage of synthetic vasculargrafts carries a high risk of infection, meaning that thereis a lack of suitable conduit in some war-injured patients. Human Acellular Vessels (HAVs) are bioengineeredvascular conduits that are cultured from human donors’smooth muscle cells and subsequently decellularized.1 TheHAV is an investigational biological product in late-stageclinical development, with over 1,000 patient-years ofexposure. After clinical implantation, the HAV repopulateswith cells, producing a living vascular tissue that may behighly resistant to infection.2,3 In March 2022, surgeons inUkraine requested the HAV for vascular repair underHumanitarian conditions. In response, the manufacturerof the HAV (Humacyte Global Inc.) worked with the International Office of the US FDA and the Ukrainian Ministry of Health to provide HAVs to five hospitals in Ukraine.Surgeons in Ukraine were trained remotely, by videoconferencing, on the procedures applicable to the HAV.Since June 2022, 13 patients who lacked autologousvein for repair have been treated with the HAV to repair arange of arteries including superficial femoral, commonfemoral, popliteal, and brachial arteries. Of these, 11 sustained limb vascular injuries in the ongoing conflict, mostlycomprising blast and shrapnel wounds. One such patient isshown in Fig. 1, who underwent repair of the commonfemoral artery on day 1, had patency of the HAV confirmedat day 52, and who began ambulating on day 119.Three patients received HAVs after failure of eithersaphenous vein (n = 2) or synthetic graft (n = 1) to repair anarterial injury. As of January 29th 2023, all HAVs retainedprimary patency, and no infections nor amputations of theaffected limbs were reported. After follow-up times rangingfrom 1 to 7 months, there have been no reports of HAVconduit infection or mechanical failure. The Ukrainereal-world trauma experience demonstrates the potentialfor regenerative medicine technologies to improve patientoutcomes in resource-limited environments.

Item Type:	Article
Additional Information:	https://doi.org/10.1016/j.lanepe.2023.100650
Uncontrolled Keywords:	травма судин, Людська безклітинна судина.
Subjects:	Vascular surgery
Divisions:	Departments > Department of Surgery №2
Depositing User:	Анастасия Жигар
Date Deposited:	02 Apr 2024 09:42
Last Modified:	02 Apr 2024 09:42
URI:	http://repo.dma.dp.ua/id/eprint/8817

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