Division of Surgical Research Annual Report 2005
Department of Surgery University Hospital Zurich Switzerland
Division of Surgical Research Department of Surgery University Hospital Rämistrasse 100 CH - 8091 Zurich 2 Photo & Graphic, Division of Surgical Research Nico Wick and Carol De Simio Content
Preface 5
1. Organisation 6
2. Research and Development 8 Cardiac Surgery 8 Tissue Engineering 8 Ischemia / Reperfusion Injury 12 Mechanical Circulatory Support 16 Robotic Surgery 18
Visceral & Transplantation Surgery 20 Hepatobiliary & Transplantation Surgery 20 Islet Cell Laboratory 28 Pancreatitis Research Laboratory 30 Colorectal Surgery Laboratory 33
Trauma Surgery 34 Trauma Immunology 34 Osteogenesis Laboratory 37 Innate Immunity Laboratory 40 Computer Assisted Trauma Surgery 43 Musculosceletal tissue conditioning 46
Plastic, Hand & Reconstructive Surgery 48 Tissue Engineering 48 Anti Aging 51
Thoracic Surgery 53 Transplantation Immunology 53 Tissue Engineering 60 Oncology 63
Surgical Intensive Care Units 67
3. Services 70 Surgical skill laboratories 70 Microsurgical laboratory 70 Histology 70 Photo and Graphic services 71 Administration 71
4. Events 72
5. Publications 73
6. Grants 75
7. Awards 78 4 Preface
Dear Colleagues
It is my pleasure to present to you the Annual Report 2005 of the Division of Surgical Research, Department of Surgery at the University Hospital Zurich.
In the year 2005 we have undergone substantial administrative reorganisation
Prof. Dr. med. and with the support of all members within the Division organisational problems Gregor Zünd, Head Division of could be solved quickly. The new facilities built in 2004 were successfully Surgical Research implemented in the daily routine and are highly appreciated by technicians and researchers. The research group of the Division of Surgical Intensive Care was integrated and could be provided with new laboratories.
The Division’s quarterly internal reports comprising the corresponding operational expenditures as well as the investments carried out allow for a qua- lity control by means of timely financial project management. The investments carried out in the past year included the acquisition of a high performance liquid chromatography (HPLC) and a reversal microscope. Both acquisitions are being used by various research groups from our Division complementing the apparatus pool accordingly.
The weekly lectures held by the Division of Surgical Research at the University Hospital Zurich are regularly attended by the members of our Division and other researchers representing an integrative part of the academic curriculum within the University, the University Hospital and the Federal Institute of Technology
It is my pleasure to thank all members within our Division and research partners of the University, University Hospital and Federal Institute of Zurich for the excellent performance and collaboration last year.
Yours sincerely
Prof. Dr. med. Gregor Zünd Head Division of Surgical Research 1. Organisation
6 1.1 Position of the Division of Surgical Research within the Department of Surgery
Department of Surgery
Prof. Dr. med. Prof. Dr. med. Prof. Dr. med. Michele Genoni Pierre - Alain Clavien, Otmar Trentz, Director Clinic Director Clinic Visceral Director Clinic Cardiac Surgery & Transpl. Surgery Trauma Surgery
Visceral & Plast. - Hand & Cardiac Surgery Transplant. Surgery Trauma Surgery Reconstr. Surgery Thoracic Surgery
Dr. med. Prof. Dr. med. Prof. Dr. med. Division of Surgical Intensive Care Units Walter Kuenzi, Walter Weder, Reto Stocker, Director a.i. Clinic Director Clinic Head of Intensive Plast. - Hand & Thoracic Surgery Care Unit Reconstr. Surgery Division of Surgical Research
Prof. Dr. med. Gregor Zünd, Head Division of Surgical Research 1.2 Structural Organisation of the Division of Surgical Research
Cardiac Surgery Research
Visceral & Transpl. Surgery Research
Prof. Dr. med. PD Dr. phil. ll Gregor Zünd, Rolf Graf, Trauma Surgery Head Division of Co-Head Division of Surgical Research Surgical Research Research
Plast.-Hand & Reconstr. Division of Surgical Surgery Research Research Thoracic Surgery Research
Surgical Intensive Care
Susanne Frehner, Research Administration Division of Surgical Research Skill Laboratories
Services
1.3 Scientific Sections within the Division of Surgical Research
Regenerative Medicine
Prof. Dr. med. Dr. phil ll Simon Philipp Wolfgang Moritz Hoerstrup Ischemia / Regenerative Reperfusion Ischemia / Medicine Injuries Reperfusion Injuries Division of Surgical Research Robotic Surgery
PD Dr. med. PD Dr. phil ll Guido Wanner, Rolf Graf Robotic Surgery Methodology
Methodology 2. Research and Development
8 2.1 Cardiac Surgery Research
Cardiovascular Regenerative Medicine
Ischemia / Reperfusion Prof. Dr. med. Prof. Dr. med. Prof. Dr. med. Injuries Simon Philipp Gregor Zünd Michele Genoni Hoerstrup Cardiac Surgery Research Circulatory Assist
Robotic Surgery
2.1.1 Cardiovascular Regenerative Medicine (Tissue Engineering and Cell Transplantation) Prof. Dr. med. Simon Philipp Hoerstrup (Director, Regenerative Medicine Program; Professor of Biomedical Engineering TU/e)
Prof. Dr. med. Dr. sc. nat. Dr. med. Simon Philipp Jens Kelm Dörthe Schmidt The Cardiovascular Regenerative Medicine Program comprises Tissue Hoerstrup Engineering and Cell Transplantation and is focused on the development and in vitro generation of novel, cell based therapies for cardiovascular applica- tions. These include tissue engineered blood vessels, heart valves as well as microscale strategies for myocardial regeneration. Presently utilized heart valve and blood vessel prostheses carry disadvantages for the patients mainly because non-living, artificial devices are inserted into the human organism. PD Dr. sc. nat. Dr. med. Anita Mol Stefan Ian Cummings PhD Student Tissue engineering enables the in vitro production of autologous, living and Neuenschwander functional replacements with the capacity of growth for congenital applicati- on as an alternative to state of the art artificial replacements. Furthermore, an additional focus is the development of cell based implants based on the design of in vitro generated microtissues to improve myocardial functionality of the diseased heart. Dr. med. Sirpa Price Prof. Dr. Alberto Weber Vijay Kumar Research projects: ■ Human Cell-Based Systems (progenitor, foetal, adult) ■ Extracellular Matrix (proteins, tensegrity) ■ Biomaterials (biodegradable, bio-active)
cand. med. cand. med. cand. med. ■ Bioreactor Systems (tension, flow) Armin Zürcher Silvan Holdener Sandro Imbach ■ Biomechanics, Computational Models, Molecular Imaging ■ Animal Models (small and large) ■ Tissue Engineered Cardiovascular Structures (Heart Valves, Vascular Grafts) ■ Microtissue-Based Implants (Myocardium) and Cell Transplantation ■ Molecular Imaging Proof of Heart Valve Tissue Engineering Concept
pre-implantation in-vivo post-explantation Autologous living tissue engineered heart valve in a sheep model, based on vascular - derived myofibroblasts and endothelial cells (Hoerstrup et al, Circulation 2000) Human Heart Valve Tissue Engineering
Heart valve tissue engineered from human marrow stromal cells (Hoerstrup et al. Circulation 2002) Human Prenatal Progenitor Cells
Native EPCs Uptake of ac-LDL vWF staining Human endothelial progenitor cells isolated from human umbilical cord blood Schmidt et al. Ann Thorac Surg. 2004
H&E staining CD 31staining vWF staining Human umbilical cord-derived endothelial progenitor cells seeded onto a living matrix enginereed from umbilical cord tissue Schmidt et al. EJCTS 2005 10
Bioreactor Development
• sized small • biocompatible materials • maintenance of sterility • static conditioning by continuous perfusion • dynamic conditioning by mimicking diastolic phase
Mol et al. Ann Biomed Eng 2005
Microscale TE for myocardial Regeneration
Gravity-mediated production of myocardial microtissue grafts. Myocardial microtissues retain heart-muscle specifi c morphology (as shown by fl uorescent staining of sarcomeric alpha-actinin), which can be used as cell grafts or as building blocks to assemble larger tissue patches of any desired shape.
Achievements 2005