Novel vascular graft grown within recipient's own peritoneal cavity.
Novel vascular graft grown within recipient's own peritoneal cavity.
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DOI：
10.1161/01.res.85.12.1173
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发表时间：
1999-12
影响因子：
20.1
通讯作者：
J. Campbell;J. Efendy;G. Campbell
中科院分区：
文献类型：
--
作者：
J. Campbell;J. Efendy;G. Campbell
克服动脉粥样硬化临床症状的一种方法是插入移植物以绕过被斑块阻塞或阻碍的动脉。然而，自体乳动脉可能不足以进行多次或重复搭桥，隐静脉可能出现曲张退行性改变，导致高压部位动脉瘤，小口径合成移植物容易诱发血栓和闭塞。因此，本研究的目的是利用宿主细胞开发一种具有任何所需长度和直径的人工血液导管，用于自体移植。将不同长度和直径的硅橡胶管插入大鼠或兔子的腹膜腔中。两周后，它已被多层肌成纤维细胞、胶原基质和单层间皮覆盖。从收获的植入物中取出硅橡胶管，并将活组织管外翻，使其类似于血管，内衬为非血栓间皮细胞（“内膜”），具有平滑肌样细胞（肌成纤维细胞）、胶原蛋白和弹性蛋白的“中层”，以及外层胶原“外膜”。组织管（10至20毫米长）通过端对端吻合术成功移植到生长它们的同一动物的切断的颈动脉或腹主动脉中。移植物保持开放状态至少 4 个月，并形成类似弹性片层的结构。肌成纤维细胞获得了更高的肌丝体积分数，并对收缩激动剂产生反应，类似于它们移植到的血管。有人建议，这些在宿主腹膜腔中生长的非血栓形成的活组织管可以开发为自体冠状动脉旁路移植物或血液透析患者的动静脉通路瘘管。
A method by which to overcome the clinical symptoms of atherosclerosis is the insertion of a graft to bypass an artery blocked or impeded by plaque. However, there may be insufficient autologous mammary artery for multiple or repeat bypass, saphenous vein may have varicose degenerative alterations that can lead to aneurysm in high-pressure sites, and small-caliber synthetic grafts are prone to thrombus induction and occlusion. Therefore, the aim of the present study was to develop an artificial blood conduit of any required length and diameter from the cells of the host for autologous transplantation. Silastic tubing, of variable length and diameter, was inserted into the peritoneal cavity of rats or rabbits. By 2 weeks, it had become covered by several layers of myofibroblasts, collagen matrix, and a single layer of mesothelium. The Silastic tubing was removed from the harvested implants, and the tube of living tissue was everted such that it now resembled a blood vessel with an inner lining of nonthrombotic mesothelial cells (the "intima"), with a "media" of smooth muscle-like cells (myofibroblasts), collagen, and elastin, and with an outer collagenous "adventitia." The tube of tissue (10 to 20 mm long) was successfully grafted by end-to-end anastomoses into the severed carotid artery or abdominal aorta of the same animal in which they were grown. The transplant remained patent for at least 4 months and developed structures resembling elastic lamellae. The myofibroblasts gained a higher volume fraction of myofilaments and became responsive to contractile agonists, similar to the vessel into which they had been grafted. It is suggested that these nonthrombogenic tubes of living tissue, grown in the peritoneal cavity of the host, may be developed as autologous coronary artery bypass grafts or as arteriovenous access fistulae for hemodialysis patients.