Priority 8 from the Heart Surgery PSP

UNCERTAINTY: Can we use 3D bioprinting or stem cell technology to create living tissues (heart valves/heart) and repair failing hearts (myocardial regeneration)? (JLA PSP Priority 8)
Overall ranking 8
JLA question ID 0088/8
Explanatory note 3D printing in combination with stem cell technology offers the potential for surgical prosthesis that have enhanced durability, low thrombogenicity, and plasticity. This would reduce the requirements for repeated procedures over the lifetime of the patient, as well as both the need for anticoagulation and risk of thrombosis. No RCTs were identified to examine 3D bio-printing. Systematic review identified 38 trials on stem cell therapy for chronic ischaemic heart disease. These trials did not demonstrate efficacy, however, there were important design limitations in all of these trials, which limit the interpretation. ~ Can stem cell therapy be of any use in heart surgery? Can stem cells be used to create transplantable components (i.e. valves) rather than use mechanical or pig or cow tissue? Is 3D printing of valves and solid hearts realistic or does it bring false hope?
Evidence

Fisher SA, Zhang H, Doree C, Mathur A, Martin-Rendon E. Stem cell treatment for acute myocardial infarction. Cochrane Database Syst Rev. 2015(9):CD006536; Fisher SA, Doree C, Mathur A, Taggart DP, Martinā€Rendon E. Stem cell therapy for chronic ischaemic heart disease and congestive heart failure. Cochrane Database of Systematic Reviews. 2016(12); Moazzami K, Roohi A, Moazzami B. Granulocyte colony stimulating factor therapy for acute myocardial infarction. Cochrane Database Syst Rev. 2013(5):CD008844.

Health Research Classification System category Cardiovascular
Extra information provided by this PSP
Original uncertainty examples Can stem cell therapy be of any use in heart surgery? ~ Can stem cells be used to create transplantable components (i.e. valves) rather than use mechanical or pig or cow tissue? ~ Is 3D printing of valves and solid hearts realistic or does it bring false hope?
Submitted by 1 x carer, 12 x healthcare professional, 1 others
PSP information
PSP unique ID 0088
PSP name Heart Surgery
Total number of uncertainties identified by this PSP. 45 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 11 July 2019