{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:07:03Z","timestamp":1789020423953,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p>\n                    Current paediatric options for pulmonary heart valve (PHV) substitutes are imperfect, requiring numerous reinterventions until maturity. Substitutes with a diameter under 15\u00a0mm have a limited service life, underscoring the critical need for small-diameter valves. To address this need, we obtained and tested decellularized, DNA-depleted, small-diameter valvular substitutes using tissue-engineered lamb PHVs. Lamb PHVs were subjected to a decellularization perfusion protocol, yielding a 3D extracellular matrix (ECM)- derived acellular scaffold. Sterility, residual nuclei (histology) and DNA content were assessed. Hemodynamic performance was assessed in a dedicated heart valve bioreactor, compared with freshly harvested PHV. Cytocompatibility was assessed using fibroblasts and endothelial cells, and the\n                    <jats:italic>ex vivo<\/jats:italic>\n                    surgical implantation feasibility was evaluated. Decellularization validation revealed preserved ECM without cell nuclei, and over 90% DNA reduction.\n                    <jats:italic>In vitro<\/jats:italic>\n                    hemodynamic assessment showed physiological behaviour with complete opening and no evidence of regurgitation or stenosis; geometric and Doppler parameters were comparable to fresh valves. Cells remained viable at 3, 7 and 14 days, and\n                    <jats:italic>ex vivo<\/jats:italic>\n                    implantations were successful, with adequate suturing. Decellularization of small ovine PHV is feasible, yielding cytocompatible scaffolds with good hemodynamics and surgical handling. Although initial results are promising, further quantitative characterization and\n                    <jats:italic>in vivo<\/jats:italic>\n                    validation are needed before clinical translation.\n                  <\/jats:p>","DOI":"10.3389\/fbioe.2026.1902783","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:31:53Z","timestamp":1789018313000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The PEDIAVALVE project \u2013 tissue-engineered pulmonary valves for paediatric valvular replacement"],"prefix":"10.3389","volume":"14","author":[{"given":"Ionela","family":"Cotfas","sequence":"first","affiliation":[{"name":"Regenerative Medicine Laboratory, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","place":["Targu Mures, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussam","family":"Al Hussein","sequence":"additional","affiliation":[{"name":"Regenerative Medicine Laboratory, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","place":["Targu Mures, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamida","family":"Al Hussein","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine and Pharmacy, I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","place":["Targu Mures, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Br\u00e2nzaniuc","sequence":"additional","affiliation":[{"name":"Regenerative Medicine Laboratory, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","place":["Targu Mures, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu Simion","family":"Cotoi","sequence":"additional","affiliation":[{"name":"Regenerative Medicine Laboratory, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","place":["Targu Mures, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Simionescu","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Clemson University","place":["Clemson, SC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Harpa","sequence":"additional","affiliation":[{"name":"Regenerative Medicine Laboratory, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","place":["Targu Mures, Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1007\/s13770-025-00735-8","article-title":"Short- and medium-term surgical outcomes of tissue-engineered pulmonary valve replacement in sheep","volume":"22","author":"Al Hussein","year":"2025","journal-title":"Tissue Eng. 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