Capping bioprosthetic tissue to reduce calcification
A treatment for bioprosthetic tissue used in implants or for assembled bioprosthetic heart valves to reduce in vivo calcification. The method includes applying a calcification mitigant such as a capping agent or an antioxidant to the tissue to specifically inhibit oxidation in tissue. Also, the method can be used to inhibit oxidation in dehydrated tissue. The capping agent suppresses the formation of binding sites in the tissue that are exposed or generated by the oxidation and otherwise would, upon implant, attract calcium, phosphate, immunogenic factors, or other precursors to calcification. In one method, tissue leaflets in assembled bioprosthetic heart valves are pretreated with an aldehyde capping agent prior to dehydration and sterilization.
1. A method for treating bioprosthetic tissue comprising:
at least partially cross-linking the bioprosthetic tissue;
capping one or both of a carboxylic acid group and an aldehyde group generated from the cross-linking of the bioprosthetic tissue; and
contacting the bioprosthetic tissue with glycerol.
2. The method of claim 1 , wherein the cross-linking is performed using glutaraldehyde.
3. The method of claim 2 , further comprising rinsing the bioprosthetic tissue with at least one of an ethanol or an ethane solution before the capping.
4. The method of claim 1 , wherein the capping is performed by exposing the bioprosthetic tissue to one or more capping agents.
5. The method of claim 4 , wherein the capping agent is selected from the group consisting of: an amine, an alkyl amine, an amino alcohol, an ethanolamine, an amino acid, a lysine, a hydroxylysine, an amino sulfonate, a taurine, an amino sulfate, a dextran sulfate, a chrondoitin sulfate, a hydrophilic multifunctional polymer, a polyvinyl alcohol, a polyethyleneimine, a hydrophobic multifunctional polymer, α-dicarbonyl, a methylglyoxal, a 3-deoxylglucosone, a glyoxal, a hydrazide, an adipic hydrazide, an N,N-disuccinimidyl carbonate, a carbodiimide, a 1-ethyl-3-[3-dimethylaminopropyl]carbodiimide hydrochloride (EDC), N-cyclohexyl-N′-(2-morpholinoethyl)carbodiimide (CMC), 1,3-dicyclohexyl carbodiimide (DCC), 2-chloro-1-methylpyridinium iodide (CMPI), an antibiotic, a cell recruiting agent, a hemocompatibility agent, an antiinflamatory agent, an antiproliferative agent, an immunogenic suppressing agent, a reducing agent, and a mono-, di- or polyepoxy alkane.
6. The method of claim 4 , wherein the capping agent(s) is one or more of an amine, an alkyl amine, an amino alcohol, and an ethanolamine.
7. The method of claim 6 , further comprising exposing the bioprosthetic tissue to a reducing agent.
8. The method of claim 7 , wherein the reducing agent is sodium borohydide.
9. The method of claim 1 , further comprising oxidizing the aldehyde group generated from the cross-linking of the bioprosthetic tissue to a carboxylic acid group prior to the capping.
10. The method of claim 1 , wherein the contacting is performed by immersing the bioprosthetic tissue in a glycerol solution.
11. The method of claim 10 , wherein the glycerol solution comprises ethanol.
12. The method of claim 10 , wherein the glycerol solution is non-aqueous.
13. The method of claim 12 , wherein the bioprosthetic tissue is immersed in the glycerol solution for a period of time sufficient to dehydrate the bioprosthetic tissue.
14. The method of claim 1 , further comprising providing the bioprosthetic tissue in a sealed package after contacting the bioprosthetic tissue with glycerol, wherein the sealed package does not contain a liquid storage solution in contact with the bioprosthetic tissue.
15. The method of claim 14 , wherein the sealed package is gas-permeable.
16. The method of claim 15 , further comprising sterilizing the bioprosthetic valve.
17. The method of claim 16 , wherein the sterilizing is performed using ethylene oxide, gamma irradiation, or electron beam irradiation.
18. The method of claim 17 , wherein the sterilizing is performed after providing the bioprosthetic tissue in the sealed package.
19. A packaged bioprosthetic heart valve comprising:
a bioprosthetic heart valve comprising an at least partially cross-linked biological tissue comprising glycerol, wherein one or both of a carboxylic acid group and an aldehyde group generated from the cross-linking of the bioprosthetic tissue is capped with a capping agent; and
a sealed package containing the bioprosthetic heart valve, wherein the sealed package does not contain a liquid storage solution in contact with the bioprosthetic heart valve.
20. The packaged bioprosthetic heart valve of claim 19 , wherein the bioprosthetic heart valve is sterilized and the sealed package is gas-permeable.