Grants We Funded

Abstract
Acquired bone deficiencies are a significant clinical problem. Failure to adequately reconstruct these defects may lead to loss of function and impairment of quality of life. Traditionally, small bone defects have been treated with non-vascularized bone grafts. These grafts, however, undergo resorption or may become infected. Larger defects and bone deficiencies in contaminated wounds require alternative reconstructive methods. The use of microsurgical bone transfer has enabled reliable transfer of large segments of bone without resorption or infection in these settings. Unfortunately, vascularized bone flaps are not always available, require significant manipulation to match the defect, and can be a source of donor site morbidity. Tissue engineering may provide an alternative method by which osseous tissues can be synthesized. Recent studies in our lab and by other investigators have demonstrated that osteoblasts can be seeded on synthetic on naturally occurring matrices and that these cells retain their ability to differentiate and mineralize. Although these findings are exciting, numerous limitations of in vitro tissue synthesis must be overcome for successful free tissue transfer. For example, reliable vascular ingrowth must occur in a timely fashion to allow oncologic reconstruction. In addition, in order to, avoid rejection and immunologic complications, the cells used for seeding of the construct should ideally be autogenous or syngeneic cells. Thus, a reliable method by which a rapidly vascularized, autogenous cell seeded osseous constructs can be synthesized would represent a significant advance in bone tissue engineering. The purpose of these experiments is to combine tissue engineering principles with recombinant DNA technology to augment cell adhesion, vascular growth, and bone synthesis.

Biography
Dr. Mehrara is a graduate of Columbia University College of Physicians and Surgeons. He completed his Plastic Surgery Residency at New York University Medical Center followed by microsurgical fellowship at UCLA Medical Center. Dr. Mehrara’s laboratory research is focused on the etiology of lymphedema and deleterious effects of radiation therapy. These fields are intimately related since radiation therapy is a significant risk factor for lymphedema. His recent research has demonstrated that the pathological findings associated with radiation therapy are related in large part to the depletion and dysfunction of resident tissue stem cells and that targeted protection of these cells can decrease tissue injury.