Research of "Autologous fibrin coated small caliber vascular prostheses improve the antithrombogenicity by less immunological response"

小口径血管假体的发展仍然具有挑战性。近年来，我们开发了一种用于血管移植的纤维蛋白涂层新技术。我们假设自体纤维蛋白涂层可以通过减少免疫反应来提高移植物的抗血栓性。我们还检查了移植后的愈合特征。方法：采用改良乙醇法制备血浆中自体（兔，a -片）或异体（人，x -片）纤维蛋白包被内径2mm的针织涤纶织物血管假体。将50只日本大白兔植入双侧颈动脉内，按兔体选择将其分为3组：a & x组（I组，n40）、a & a组（II组，n=5）、x & x组（III组，n=5）。为评价移植物通畅度、抗移植物血清抗体、^<111 bb0血小板显像及组织学指标，ⅰ组于术后第1、3、7、10、14、30、60、180天（n=5）进行移植。连续测定II组和III组血清免疫球蛋白G （IgG）、M （IgM）、组织型纤溶酶原激活剂（tPA）和纤溶酶原激活剂抑制剂-1 （PAI-1）水平，比较免疫、凝血和纤溶反应。结果：除1例x线移植外，其余移植均通畅，无狭窄及血栓形成。在POD 60上，a -移植物的整个表面覆盖单层内皮样细胞。1组抗移植物血清抗体在490 nm处的最大光密度为0.17±0.02])，最大血小板沉积（10.3±1.6 × 10^6/mm^2）显著小于x -组（0.46±0.06 od, 17.4±1.4 × 10^6/mm^2, p<0.0001）。虽然在POD 7 ~ 14期间，血清IgG、IgM、tPA和PAI-1水平在移植物纤维蛋白降解时升高，但II组明显低于III组（p< 0.05）。O1,方差分析)。两组PAI-1/tPA比值均随移植物血小板沉积的增加而降低。结论：自体纤维蛋白涂层可通过减少免疫反应提高血管的抗血栓性，具有应用于杂交小口径血管假体的潜力。少

Introduction : Development of small caliber vascular prostheses is still challenging. Recently we have developed a new technique of fibrin coatings for vascular grafts. We hypothesized that autologous fibrin coatings could improve the antithrombogenicity of grafts by less immunological response. We also examine the graft healing characteristics after implantation.Methods : Knitted polyester fabric vascular prostheses, 2mm in internal diameter, were coated with autologous (rabbit, A-graft) or xenologous (human, X-graft) fibrin by modified ethanol method from plasma. Fifty Japanese white rabbits were implanted with the grafts in bilateral carotid arteries and divided into three groups by the selection of grafts in the individual rabbit : A&X-grafts (group I, n40), A&A-grafts (group II, n=5), X&X-grafts (group III, n=5). To evaluate graft patency, anti-graft serum antibody, ^<111>Indium platelet scintigraphy and histology, the grafts in group I were explanted on postoperative days (PODs) … More 1, 3, 7, 10, 14, 30, 60, 180 (n=5 for each). Serum levels of immunoglobulin G (IgG) and M (IgM), tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) in group II and III were measured serially to compare immunological, coagulative and fibrinolytic reactions.Rsults : All of grafts except one X-graft on POD 10 were patent without stenosis and thrombus. Monolayer endothelial-like cells were covered on the entire surface of the A-grafts on POD 60. In group I, the maximal anti-graft serum antibodies (0.17±0.02 optical density at 490 nm [O.D.]) and the maximal platelet deposition (10.3±1.6x10^6/mm^2) in A-grafts were significantly less than those in X-grafts (0.46±0.06 O.D. and 17.4±1.4x10^6/mm^2, respectively ; p<0.0001 in both). Although serum levels of IgG, IgM, tPA and PAI-1 were increased at the time of fibrin degradation of grafts during POD 7 to 14, those in group II were significantly less than those in group III (p<0.O1, ANOVA). The PAI-1/tPA ratio in both groups was decreased as platelet deposition of the grafts was increased.Conclusion : These findings suggest that autologous fibrin coatings improve the antithrombogenicity by less immunological response and have a potential use for hybrid small caliber vascular prostheses. Less