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Ann Surg. 2018 Jun;267(6):1191-1201. doi: 10.1097/SLA.0000000000002181.

Decellularization of the Porcine Ear Generates a Biocompatible, Nonimmunogenic Extracellular Matrix Platform for Face Subunit Bioengineering.

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Pôle de Morphologie (MORF), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
Pôle de Chirurgie Expérimentale et Transplantation (CHEX), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
Department of Plastic and Reconstructive Surgery, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Department of Surgery, Section of Transplantation, Wake Forest School of Medicine, Winston-Salem, NC.
Institute of Mechanics, Materials and Civil Engineering (iMMC), Université catholique de Louvain, Louvain-la-Neuve, Belgium.
Avantea Laboratory of Reproductive Technologies, Cremona, Italy.
Avantea Foundation, Cremona, Italy.
Department of Veterinary Medical Sciences, University of Bologna, Ozzano Emilia, Italy.
General Surgery, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy.



The purpose of this study was to assess whether perfusion-decellularization technology could be applied to facial grafts.


Facial allotransplantation remains an experimental procedure. Regenerative medicine techniques allow fabrication of transplantable organs from an individual's own cells, which are seeded into extracellular matrix (ECM) scaffolds from animal or human organs. Therefore, we hypothesized that ECM scaffolds also can be created from facial subunits. We explored the use of the porcine ear as a clinically relevant face subunit model to develop regenerative medicine-related platforms for facial bioengineering.


Porcine ear grafts were decellularized and histologic, immunologic, and cell culture studies done to determine whether scaffolds retained their 3D framework and molecular content; were biocompatible in vitro and in vivo, and triggered an anti-MHC immune response from the host.


The cellular compartment of the porcine ear was completely removed except for a few cartilaginous cells, leaving behind an acellular ECM scaffold; this scaffold retained its complex 3D architecture and biochemical components. The framework of the vascular tree was intact at all hierarchical levels and sustained a physiologically relevant blood pressure when implanted in vivo. Scaffolds were biocompatible in vitro and in vivo, and elicited no MHC immune response from the host. Cells from different types remained viable and could even differentiate at the scale of a whole-ear scaffold.


Acellular scaffolds were produced from the porcine ear, and may be a valuable platform to treat facial deformities using regenerative medicine approaches.

[Indexed for MEDLINE]

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