Creation of a Large Adipose Tissue Construct in Humans Using a Tissue-engineering Chamber: A Step Forward in the Clinical Application of Soft Tissue Engineering

• Tissue engineering has the potential to offer exciting alternatives for the repair of soft tissues and organ development,
• The tissue-engineering chamber has been shown to support tissue growth and the generation of specialized organs in animals.
• Here we report on the use of this chamber in humans for the successful generation of new adipose tissue.Tissue engineering has traditionally relied on the combination of cells and scaffolds, which are subsequently implanted into the patient. However, such paradigm is limited to tissues that are thin enough to rely on diffusion for survival or that have a low metabolic rate. The tissue-engineering chamber represents an interesting approach to circumvent these obstacles, as it is able to support the growth of well-vascularized blocks of specialized tissues of varying kinds. This work presents the use of such chamber in five human patients, one of which generated a large three-dimensional well-vascularized piece of adipose tissue, probably the largest and thickest engineered tissue construct reported to date.

Tissue engineering is currently exploring new and exciting avenues for the repair of soft tissue and organ defects. Adipose tissue engineering using the tissue engineering chamber (TEC) model has yielded promising results in animals; however, to date, there have been no reports on the use of this device in humans. Five female post mastectomy patients ranging from 35 to 49 years old were recruited and a pedicled thoracodorsal artery perforator fat flap ranging from 6 to 50 ml was harvested, transposed onto the chest wall and covered by an acrylic perforated dome-shaped chamber ranging from 140 to 350 cm3. Magnetic resonance evaluation was performed at three and six months after chamber implantation. Chambers were removed at six months and samples were obtained for histological analysis. In one patient, newly formed tissue to a volume of 210 ml was generated inside the chamber. One patient was unable to complete the trial and the other three failed to develop significant enlargement of the original fat flap, which, at the time of chamber explantation, was encased in a thick fibrous capsule. Our study provides evidence that generation of large well-vascularized tissue engineered constructs using the TEC is feasible in humans.