A self-renewing, tissue-engineered vascular graft for arterial reconstruction.
A self-renewing, tissue-engineered vascular graft for arterial reconstruction.
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DOI：
10.1016/j.jtcvs.2007.06.039
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发表时间：
2008-07
期刊：
影响因子：
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通讯作者：
K. Torikai;H. Ichikawa;Koichiro Hirakawa;G. Matsumiya;T. Kuratani;S. Iwai;Atsuhiro Saito;N. Kawaguchi;N. Matsuura;Y. Sawa
中科院分区：
文献类型：
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作者：
K. Torikai;H. Ichikawa;Koichiro Hirakawa;G. Matsumiya;T. Kuratani;S. Iwai;Atsuhiro Saito;N. Kawaguchi;N. Matsuura;Y. Sawa
目的已经研究了各种组织工程血管移植物，以克服传统假体的临床缺点。以前的组织工程血管移植物通常需要术前进行细胞操作或使用生物反应器来提高性能，并且其机械性能不足。我们专注于原位细胞化的概念，开发了一种用于动脉重建的组织工程血管移植物，无需任何预处理即可促进自体组织的更新。方法该移植物内部由与胶原复合的针织聚乙醇酸组成，为组织生长提供支架，外部由编织聚左旋乳酸用于加固。所有成分均具有生物相容性和可生物降解性，具有出色的细胞亲和力。将内径为10毫米、长度为30毫米的移植物植入猪主动脉，并在移植后12个月评估其效用。结果在整个观察期间，所有外植体均处于开放状态，没有血栓形成或动脉瘤变化的迹象。在植入后的早期阶段证实了新介质中存在具有适当完整性的内皮化以及功能平滑肌细胞的平行积累，这些细胞对血管反应剂作出反应。定量证明了充足的胶原蛋白合成和弹性蛋白的缺乏。体内研究的动态评估和长期结果表明植入物具有足够的耐用性。结论移植物显示出良好的原位细胞化的形态学证据、术后 12 个月耐受动脉压的令人满意的耐用性以及获得生理血管舒缩反应性的潜力。这些结果表明我们的组织工程血管移植物显示出作为动脉导管假体的前景。
OBJECTIVEVarious tissue-engineered vascular grafts have been studied to overcome the clinical disadvantages of conventional prostheses. Previous tissue-engineered vascular grafts have generally required preoperative cellular manipulation or use of bioreactors to improve performance, and their mechanical properties have been insufficient. We focused on the concept of in situ cellularization and developed a tissue-engineered vascular graft for arterial reconstruction that would facilitate renewal of autologous tissue without any pretreatment.METHODSThe graft comprised an interior of knitted polyglycolic acid compounded with collagen to supply a scaffold for tissue growth and an exterior of woven poly-l-lactic acid for reinforcement. All components were biocompatible and biodegradable, with excellent cellular affinity. The grafts, measuring 10 mm in internal diameter and 30 mm in length, were implanted into porcine aortas, and their utility was evaluated to 12 months after grafting.RESULTSAll explants were patent throughout the observation period, with no sign of thrombus formation or aneurysmal change. Presence in the neomedia of endothelialization with proper integrity and parallel accumulation of functioning smooth muscle cells, which responded to vasoreactive agents, was confirmed in an early phase after implantation. Sufficient collagen synthesis and lack of elastin were quantitatively demonstrated. Dynamic assessment and long-term results of the in vivo study indicated adequate durability of the implants.CONCLUSIONThe graft showed morphologic evidence of good in situ cellularization, satisfactory durability to withstand arterial pressure for 12 postoperative months, and the potential to acquire physiologic vasomotor responsiveness. These results suggest that our tissue-engineered vascular graft shows promise as an arterial conduit prosthesis.