In patients with life-threatening pulmonary failure, extracorporeal membrane oxygenation (ECMO) can ensure adequate respiratory gas exchange. In order to remove excess carbon dioxide and oxygenate the blood, large blood vessels are accessed and the blood flow is directed through a blood-gas exchanger (oxygenator) enabling the vital gas exchange via a gas permeable membrane.
Recent substantial advances facilitate mid-term use of ECMO systems but its application is associated with inflammatory reactions, hemolysis, bleeding and thrombosis. These complications are ascribed to the poor hemocompatibility of the gas permeable membrane that is in direct contact with the blood and prevent long-term application of ECMO.
In the EndOxy research project, we address the core issue of limited hemocompatibility and propose a biohybrid approach with endothelial cells. In the human body, endothelial cells line the lumen of blood vessels forming a natural non-thrombogenic surface known not to elicit inflammatory and coagulatory responses in direct contact with blood. Thus, lining the oxygenator’s membranes with autologous endothelial cells (so‑called endothelialization) promises better hemocompatibility.
The cell coating places additional requirements on the design of such a biohybrid lung. In particular, the gas exchange performance has to be maximized, while maintaining an integral and functional cell coating that allows for long-term lung support. For this reason, we envision the development and evaluation of a novel biohybrid lung assist device that is based on the concept of a flat sheet membrane oxygenator. In contrast to current lung assist devices, the EndOxy device will be distinguished by enhanced hemocompatibility and gas exchange performance offering patients with chronic lung diseases long-term lung support.
Within the DFG-funded Priority Program “Towards an Implantable Lung” (Link: https://www.ukaachen.de/kliniken-institute/klinik-fuer-anaesthesiologie/forschung/spp-towards-an-implantable-lung) two projects are currently carried out at BioTex:
EndoSpray Efficient cell coating of biohybrid lungs by atomization of shear-stress resistant endothelial cells derived from induced pluripotent stem cells
EndOxy in Flame Influence of a Biohybrid Lung on Inflammatory Pathways and Immune System-Endothelial Cell-Interaction