WO1986002273A1 - Epidermalizing the surface of dermal-equivalent - Google Patents

Epidermalizing the surface of dermal-equivalent Download PDF

Info

Publication number
WO1986002273A1
WO1986002273A1 PCT/US1985/001913 US8501913W WO8602273A1 WO 1986002273 A1 WO1986002273 A1 WO 1986002273A1 US 8501913 W US8501913 W US 8501913W WO 8602273 A1 WO8602273 A1 WO 8602273A1
Authority
WO
WIPO (PCT)
Prior art keywords
equivalent
skin
dermal
cells
punch biopsies
Prior art date
Application number
PCT/US1985/001913
Other languages
French (fr)
Inventor
Eugene Bell
Louis Dubertret
Original Assignee
Eugene Bell
Louis Dubertret
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Eugene Bell, Louis Dubertret filed Critical Eugene Bell
Priority to AT85904951T priority Critical patent/ATE56620T1/en
Priority to DE8585904951T priority patent/DE3579810D1/en
Publication of WO1986002273A1 publication Critical patent/WO1986002273A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/60Materials for use in artificial skin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14Macromolecular materials
    • A61L27/22Polypeptides or derivatives thereof, e.g. degradation products
    • A61L27/24Collagen
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005The prosthesis being constructed from a particular material
    • A61F2310/00365Proteins; Polypeptides; Degradation products thereof

Definitions

  • This invention is in the fields of biology and . 5 medicine and particularly relates to the . preparation of a living skin-equivalent which can be used to replace removed or damaged skin, particularly in human beings.
  • tissue-equivalents employing contractile agents incorporated into the lattices.
  • con ⁇ tractile agents include fibroblast cells and blood platelets .
  • the present invention is based upon the discov- 30 ery that skin-equivalent can be formed by modifying the procedures disclosed in Serial No. 381,978.
  • punch biopsies of skin are • incorporated into dermal-equivalent as a source of keratinocyte cells. It has now been found that such procedures result in excellent overgrowth of the dermal-equivalent by keratinocyte cells.
  • vSuch advantages include the fact that a differen- tiated epidermis can be formed in a relatively short period of time. Additionally, a small punch biopsy of skin, e.g. 2 millimeters, can be employed to cover a large area, e.g. 1 square centimeter (a 50 time amplification) . The area of a graft prepared by these techniques can be great because a number of punch biopsies can be inserted into a dermal- equivalent. Such punch biopsies can be inserted at the time that the dermal-equivalent is formed, or at a subsequent time.
  • Overgrowth of the punch biopsy is itself a selection process since only keratinocyte cells overgrow the dermal equivalent.
  • the overgrowth is free of dendritic cells.
  • the skin-equivalent formed by the use of punch biopsies may itself provide a source of material useful for production of additional skin-equiva ⁇ lents.
  • punch biopsies from a skin- equivalent may be employed in the production of other skin-equivalents.
  • stratum corneum that develops from skin-equivalents employing punch biopsies of skin is very similar to a normal stratum corneum.
  • the dermal/epidermal adherence • appears to be improved ' when punch biopsies of skin are employed compared to the previously employed plating techniques.
  • the punch biopsy method also accommodates well for application of other cells to the skin- equivalents.
  • pigment cells called melanocytes
  • melanocytes have been applied to the exposed surface of dermal-equivalent before they are over ⁇ grown with keratinocyte cells emanating from the punch biopsies.
  • melanocytes cover the melanocytes as they form a continuous layer of cells over the dermal equivalent.
  • the melanocytes become functional and contribute pigment to the keratinocyte layer.
  • the use of punch biopsies for epidermalizing the surface of dermal-equivalents also allows the immediate therapeutic clinical use of the skin- equivalents.
  • Dermal-equivalents can be cryopre-
  • the method is also very convenient for quantitative study of dermal/ epidermal interactions and for pharmacological testing.
  • Figure 1 is a photograph of a skin-equivalent prepared according to this invention
  • Figure 2 is a photograph illustrating applica ⁇ tion of a skin-equivalent according to this inven- * tion to a recipient.
  • the techniques of this invention are modifica ⁇ tions of the basic techniques employed in producing skin-equivalents by the methods described in Serial ⁇
  • Hydrated collagen lattices are prepared employ- ing collagen derived from rat tail tendon, calf skin collagen, or other sources. Solutions of collagen are prepared and maintained under slightly acidic conditions. Lattices are formed by adding fibro- blast cells, or other contractile agents, with nutrient medium and base which raises the pH suffi ⁇ ciently to induce fibrillogenesis and gel formation. Fibroblast cells, one example of a contractile agent, can be obtained from ⁇ man skin or from any human or animal tissue. A convenient technique for forming the lattice containing cells involves neutralizing an acidic collagen solution and rapidly combining it with cells and nutrient medium. Upon neutralization, collagen fibrils form and the lattice gels with fibroblast cells homogeneously dispersed therethrough.
  • the cells and collagen lattice are then maintained under conditions which allow the cells to attach to the * collagen lattice and to contract it to a fraction of its original size, thereby providing the dermal-equivalent.
  • Another contractile agent is blood platelets, which in many cases, can be obtained from the blood
  • Plate- lets are separated from whole blood by centrifuga- tion or other techniques for separating blood components from whole blood.
  • punch biopsies of skin can be obtained from the skin of a mouse, rat or human being, for example. These are typically obtained using cylindrical stainless steel punches which are typically in sizes of 2 or 4 mm in diameter. Punch biopsies are now routinely taken from human subjects for physio- pathological or therapeutic uses.
  • the skin biopsies taken with the punch can be incorporated into the dermal-equivalent lattice when it is poured.
  • the biopsy is positioned so that the epidermis can grow out at the level of -the upper surface of the dermal-equivalent.
  • the biopsy is held in place because the surrounding collagen lattice is con ⁇ tracted by the fibroblasts or other contractile agent. Inserting the biopsy at the * center of the dermal-equivalent results in radial outgrowth which-.- covers the dermal-equivalent. Outgrowth occurs as a circular sheet that consists of multiple layers of- .- keratinocyte cells. All phases of keratinocyte differentiation are represented in the epidermis, even close to the growing edge including a morpholo ⁇ gically normal stratum corneum. The granular layer of the differentiated epidermis contains membrane coating granules (Odlund granules) as observed in the epidermis, j ln vivo.
  • Keratinocyte cells from the primary biopsy have been subcultivated by taking punch biopsies from the skin-equivalent, i ⁇ i vitro. These starters of subcultures are handled in the same way as the original punch biopsies and are embedded in newly cast dermal-equivalents.
  • the rate of growth of epidermis from the punch is speeded up but an upshift to 1.5-2.0 x 10 ⁇ 3 M Ca +: is needed to simulate differentiation and keratinization.
  • FIG. 1 is a photograph of a skin-equivalent constituted with punch biopsies which serve as a source of keratinocyte cells that grow out and over the underlying dermal-equivalent.
  • the punch biop ⁇ sies were taken from a human donor. Each punch is surrounded by a halo that signifies the presence of a radially expanding epidermis.
  • Figure 2 is a photograph of a skin-equivalent being applied to a human patient1
  • the skin-equivalent described herein is suit- able for the treatment of a wound to the skin of a human being or other mammal. It is particularly suitable for treating massive burns and for treat ⁇ ment of a variety of genetic and other disorders that require skin replacement.

Abstract

An improvement in the preparation of living skin-equivalents from contracted hydrated collagen lattices having keratinocyte cells on the surface. In this improvement, punch biopsies of skin are employed to provide a source of keratinocyte cells to the lattices.

Description

ι*< EPIDERMALIZING THE SURFACE OF DERMAL-EQUIVALENT
Description*
Technical Field
This invention is in the fields of biology and . 5 medicine and particularly relates to the . preparation of a living skin-equivalent which can be used to replace removed or damaged skin, particularly in human beings.
Background Art
10 " U. S . Serial No. 381 , 978 , filed May 26 , 1982 , describes methods by which living tissue-equivalents can be formed. These living tissue-equivalents are produced by forming hydrated collagen lattices , zLn . vitro. Such lattices are contracted into living
15 tissue-equivalents employing contractile agents incorporated into the lattices. Examples of con¬ tractile agents include fibroblast cells and blood platelets .
Skin-equivalents are. described in Serial No.
20 381 , 978 which are produced by plating keratinocyte cells on dermal— equivalents formed from hydrated collagen lattices contracted with a contractile agent. These skin-equivalents are uniquely differ¬ ent from previously described artificial skin
25 because their basic organization is like that of skin and their living constituent cells may even be donated by a potential graft recipient.
Summary of the Invention
The present invention is based upon the discov- 30 ery that skin-equivalent can be formed by modifying the procedures disclosed in Serial No. 381,978. In the modified procedures, punch biopsies of skin are incorporated into dermal-equivalent as a source of keratinocyte cells. It has now been found that such procedures result in excellent overgrowth of the dermal-equivalent by keratinocyte cells.
The use of punch biopsies as a technique for supplying keratinocyte cells has advantages, in many
1 cases, over the previously employed technique of plating keratinocyte cells on the dermal-equivalent.
*vSuch advantages include the fact that a differen- tiated epidermis can be formed in a relatively short period of time. Additionally, a small punch biopsy of skin, e.g. 2 millimeters, can be employed to cover a large area, e.g. 1 square centimeter (a 50 time amplification) . The area of a graft prepared by these techniques can be great because a number of punch biopsies can be inserted into a dermal- equivalent. Such punch biopsies can be inserted at the time that the dermal-equivalent is formed, or at a subsequent time.
Overgrowth of the punch biopsy is itself a selection process since only keratinocyte cells overgrow the dermal equivalent. The overgrowth is free of dendritic cells.
The skin-equivalent formed by the use of punch biopsies may itself provide a source of material useful for production of additional skin-equiva¬ lents. In other words, punch biopsies from a skin- equivalent may be employed in the production of other skin-equivalents. From the experimental results obtained, it also appears that the stratum corneum that develops from skin-equivalents employing punch biopsies of skin is very similar to a normal stratum corneum. In many .cases, the dermal/epidermal adherence appears to be improved' when punch biopsies of skin are employed compared to the previously employed plating techniques.
The punch biopsy method also accommodates well for application of other cells to the skin- equivalents. For example, pigment cells, called melanocytes, have been applied to the exposed surface of dermal-equivalent before they are over¬ grown with keratinocyte cells emanating from the punch biopsies.. Experimentally, it has been shown that the keratinocytes cover the melanocytes as they form a continuous layer of cells over the dermal equivalent. The melanocytes become functional and contribute pigment to the keratinocyte layer. The use of punch biopsies for epidermalizing the surface of dermal-equivalents also allows the immediate therapeutic clinical use of the skin- equivalents. Dermal-equivalents can be cryopre-
Λ, served and held ready to receive punch biopsies for epidermalization at any time. The method is also very convenient for quantitative study of dermal/ epidermal interactions and for pharmacological testing.
Brief Description of the Figures Figure 1 is a photograph of a skin-equivalent prepared according to this invention; and Figure 2 is a photograph illustrating applica¬ tion of a skin-equivalent according to this inven- * tion to a recipient.
Best Mode for Carrying Out the Invention The techniques of this invention are modifica¬ tions of the basic techniques employed in producing skin-equivalents by the methods described in Serial ι
No. 381,978. Therefore, the teachings in Serial No. 381,978 relating to the preparation of skin- equivalents are hereby incorporated into this application by reference.
The techniques of Serial No. 581,978 will now be discussed briefly.
Hydrated collagen lattices are prepared employ- ing collagen derived from rat tail tendon, calf skin collagen, or other sources. Solutions of collagen are prepared and maintained under slightly acidic conditions. Lattices are formed by adding fibro- blast cells, or other contractile agents, with nutrient medium and base which raises the pH suffi¬ ciently to induce fibrillogenesis and gel formation. Fibroblast cells, one example of a contractile agent, can be obtained from ϊ man skin or from any human or animal tissue. A convenient technique for forming the lattice containing cells involves neutralizing an acidic collagen solution and rapidly combining it with cells and nutrient medium. Upon neutralization, collagen fibrils form and the lattice gels with fibroblast cells homogeneously dispersed therethrough. The cells and collagen lattice are then maintained under conditions which allow the cells to attach to the* collagen lattice and to contract it to a fraction of its original size, thereby providing the dermal-equivalent.. There are other contractile agents, in addition to .. fibroblast cells. These include smooth muscle cells, striated muscle cells. and heart muscle cells.
Another contractile agent is blood platelets, which in many cases, can be obtained from the blood
1 of a potential tissue-equivalent recipient. Plate- lets are separated from whole blood by centrifuga- tion or other techniques for separating blood components from whole blood.
As described above, overgrowth of the dermal- equivalent by keratinocyte cells is achieved. accord- ing to this invention employing punch biopsies of skin. Such punch-biopsies can be obtained from the skin of a mouse, rat or human being, for example. These are typically obtained using cylindrical stainless steel punches which are typically in sizes of 2 or 4 mm in diameter. Punch biopsies are now routinely taken from human subjects for physio- pathological or therapeutic uses. The skin biopsies taken with the punch can be incorporated into the dermal-equivalent lattice when it is poured. The biopsy is positioned so that the epidermis can grow out at the level of -the upper surface of the dermal-equivalent. The biopsy is held in place because the surrounding collagen lattice is con¬ tracted by the fibroblasts or other contractile agent. Inserting the biopsy at the* center of the dermal-equivalent results in radial outgrowth which-.- covers the dermal-equivalent. Outgrowth occurs as a circular sheet that consists of multiple layers of- .- keratinocyte cells. All phases of keratinocyte differentiation are represented in the epidermis, even close to the growing edge including a morpholo¬ gically normal stratum corneum. The granular layer of the differentiated epidermis contains membrane coating granules (Odlund granules) as observed in the epidermis, jln vivo. Normal epidermis differen¬ tiation -is also evidenced by the presence of the 67k dalton keratin in extracts of the newly formed epidermis. _ . . Overgrowth of a 5.5 cm diameter dermal- equivalent, before contraction of the lattice, by primary cells from a punch biopsy taken from a human or animal donor takes about 10 days in a typical case. For contrast, plated keratinocyte cells sometimes cover a dermal-equivalent of the same size in a shorter time, e.g., 4-7 days, but the coverage is not always multi-layered and is sometimes incpmplete.
Keratinocyte cells from the primary biopsy have been subcultivated by taking punch biopsies from the skin-equivalent, iτi vitro. These starters of subcultures are handled in the same way as the original punch biopsies and are embedded in newly cast dermal-equivalents. By reducing the Ca ++ concentration to 0.05 x 10~ M, the rate of growth of epidermis from the punch is speeded up but an upshift to 1.5-2.0 x 10~3 M Ca +: is needed to simulate differentiation and keratinization.
In one series of experiments, a to'tal of 80 skin-equivalents were fabricated employing punch biopsies from rat and mouse skin. Half were consti¬ tuted with punch biopsies of- 2.0 mm diameter, and the other half with punches of 4.0 mm diameter.
Another series of experiments employed 2.0 mm
- punch biopsies from donated human foreskin, while still yet another employed punches from the thigh region of a human donor who was the graft recipient, i.e. the recipient of the skin-equivalent consti¬ tuted with autogenous cells. However, allogenic cells can also be used. Figure 1 is a photograph of a skin-equivalent constituted with punch biopsies which serve as a source of keratinocyte cells that grow out and over the underlying dermal-equivalent. The punch biop¬ sies were taken from a human donor. Each punch is surrounded by a halo that signifies the presence of a radially expanding epidermis.
Figure 2 is a photograph of a skin-equivalent being applied to a human patient1
Industrial Applicability The skin-equivalent described herein is suit- able for the treatment of a wound to the skin of a human being or other mammal. It is particularly suitable for treating massive burns and for treat¬ ment of a variety of genetic and other disorders that require skin replacement. Equivalents
Those skilled in the art will recognize, or be able to ascertain using no more, than routine experi¬ mentation, other equivalents for the specific materials and steps described-herein. Such equiva¬ lents are intended to be included within the scope of the following claims.

Claims

CLAIMS : . :
1. A method of forming a skin-equivalent, com¬ prising: a. forming an acidic solution.of colla- - 5 gen; b. combining contractile cells and nutrient medium with said acidic solution of collagen; c. raising the pH of said solution of 10 collagen to a level sufficient to precipitate collagen fibrils into a hydrated collagen lattice containing said contractile cells; d. incorporating one or more punch biopsies of skin into said hydrated collagen
15 lattice; and e. maintaining said hydrated collagen lattice containing said punch biopsies under conditions sufficient for the contractile cells to contract the hydrated collagen lattice into
20 a dermal-equivalent and sufficient to allow keratinocyte cells from said punch biopsies to overgrow the surface of said dermal equivalent thereby producing a skin-equivalent.
2. A method of Claim 1 wherein steps b and c are 25 done simultaneously.
3. A skin-equivalent formed by the method of Claim 1 or Claim 2.
4. In a method of forming skin-equivalent, *includ¬ ing the steps of: (a) forming a hydrated collagen lattice incorporating a living cellu¬ lar contractile agent therein; (b) maintaining • said lattice and said contractile agent under - conditions sufficient for said agent to con¬ tract said collagen lattice to form living, dermal-equivalent; (c) overgrowing keratinocyte cells upon said dermal equivalent; and (d) maintaining said dermal equivalent under conditions sufficient for growth, of said living cellular contractile agent and said keratino¬ cyte cells to thereby produce a skin-equiva- lent: The improvement wherein keratinocyte cells are grown on the surface of said dermal- equivalent by incorporating one or more punch biopsies of skin into said dermal- equivalent and maintaining said dermal- equivalent with the punch biopsies therein under conditions sufficient for keratino¬ cyte cells from said skin biopsies to overgrow the surface of said dermal- equivalent.
5. A method of treating a wound to or disease of the skin of a recipient, comprising: a. forming a hydrated collagen lattice incorporating a living cellular contractile agent therein; b. removing one or more punch biopsies of skin from a donor; c. incorporating said punch biopsies removed from the donor into said hydrated collagen lattice; d. maintaining the hydrated collagen lattice containing said punch biopsies under conditions sufficient for the contractile cells to contract the hydrated collagen lattice and sufficient to allow keratinocyte cells from said punch biopsies of skin to overgrow the • • surface of said hydrated collagen lattice thereby producing a skin-equivalent for said recipient; and e. applying said skin-equivalent to the wound of said recipient.
6. A method of Claim 5 wherein said recipient is a human being.
7. A method of Claim 6 wherein said donor is a human being.
8. A method of Claim 5 wherein said recipient and said donor comprise the same human being.
9. A method of Claims 5 or 8 wherein said contrac¬ tile agent comprises fibroblast cells.
10.* A method of preparing skin-equivalent, com¬ prising: a. forming a hydrated- collagen lattice incorporating a living cellular contractile . agent therein; b. maintaining the hydrated collagen lattice and said contractile agent.under conditions sufficient for said agent to con¬ tract said collagen lattice to form living dermal-equivalent;r c. growing keratinocyte cells upon the surface of said dermal equivalent to form a skin-equivalent; d. removing one or more punch biopsies from said skin-equivalent; e. incorporating said punch biopsies into another hydrated collagen lattice containing a living1 cellular contractile agent; f. maintaining said another hydrated collagen lattice containing a living cellular contractile agent and said punch biopsies under conditions sufficient for formation of another skin-equivalent therefrom; and . g. optionally repeating steps d-f to produce further skin-equivalents.
PCT/US1985/001913 1984-10-09 1985-10-04 Epidermalizing the surface of dermal-equivalent WO1986002273A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AT85904951T ATE56620T1 (en) 1984-10-09 1985-10-04 EPIDERMALIZATION OF THE SURFACE OF AN ARTIFICIAL DERMAS.
DE8585904951T DE3579810D1 (en) 1984-10-09 1985-10-04 EPIDERMALIZATION OF THE SURFACE OF AN ARTIFICIAL DERMAS.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US658,499 1984-10-09
US06/658,499 US4604346A (en) 1984-10-09 1984-10-09 Skin-equivalent prepared by the use of punch biopsy

Publications (1)

Publication Number Publication Date
WO1986002273A1 true WO1986002273A1 (en) 1986-04-24

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Country Status (5)

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US (1) US4604346A (en)
EP (1) EP0197090B1 (en)
JP (1) JPS62500435A (en)
DE (1) DE3579810D1 (en)
WO (1) WO1986002273A1 (en)

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Cited By (17)

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US5667961A (en) * 1987-03-26 1997-09-16 Centre International De Recherches Dermatologigues Galderma (Cird Galderma) Skin substitute
US5639654A (en) * 1987-03-26 1997-06-17 Centre International De Recherches Dermatologiques Process for creating a skin substitute and the resulting skin substitute
EP0361957A1 (en) * 1988-09-30 1990-04-04 Organogenesis Inc. Tissue equivalents and methods of preparation thereof
USRE35399E (en) * 1990-04-24 1996-12-10 Eisenberg; Mark Composite living skin equivalents
WO1991016010A1 (en) * 1990-04-24 1991-10-31 Mark Eisenberg Composite living skin equivalents
US5326356A (en) * 1990-06-01 1994-07-05 Fidia S.P.A. Biocompatible perforated membranes, processes for their preparation, their use as a support in the in vitro growth of epithelial cells, the artificial skin obtained in this manner, and its use in skin grafts
US5650164A (en) * 1990-06-01 1997-07-22 Fidia S.P.A. Process for preparing artificial skin with biocompatible perforated membranes
US5658331A (en) * 1990-06-01 1997-08-19 Fidia S.P.A. Biocompatible perforated membranes, processes for their preparation, their use as a support in the in vitro growth of epithelial cells, the artificial skin obtained in this manner, and its use in skin grafts
EP0462426A1 (en) * 1990-06-01 1991-12-27 FIDIA S.p.A. Biocompatible perforated membranes and their use as artificial skin
US5192312A (en) * 1991-03-05 1993-03-09 Colorado State University Research Foundation Treated tissue for implantation and methods of treatment and use
US5772695A (en) * 1991-03-05 1998-06-30 Colorado State University Research Foundation Treated tissue for implantation and methods of treatment and use
US5855617A (en) * 1991-03-05 1999-01-05 Colorado State University Research Foundation Treated tissue for implantation and methods of treatment and use
US5863296A (en) * 1991-03-05 1999-01-26 Colorado State University Research Foundation Treated tissue for implantation and methods of treatment and use
US5613982A (en) * 1994-03-14 1997-03-25 Cryolife, Inc. Method of preparing transplant tissue to reduce immunogenicity upon implantation
US5632778A (en) * 1994-03-14 1997-05-27 Cryolife, Inc. Treated tissue for implantation and methods of preparation
US5843182A (en) * 1994-03-14 1998-12-01 Cryolife, Inc. Treated tissue for implantation and methods of preparation
US5899936A (en) * 1994-03-14 1999-05-04 Cryolife, Inc. Treated tissue for implantation and methods of preparation

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JPS62500435A (en) 1987-02-26
US4604346A (en) 1986-08-05
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EP0197090B1 (en) 1990-09-19
DE3579810D1 (en) 1990-10-25

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