Fundamental study of development of autologous tissue fragmented vascular prosthesis for A-C bypass use

我们开发了一种新的方法，以加速愈合过程中的新生内膜形成织物人造血管自体组织碎片移植技术。应用该技术研制了一种小直径的冠状动脉搭桥术用人造血管。作为自体组织，我们采用外周静脉组织、网膜组织、皮下脂肪组织和骨髓组织。这些组织被切碎并悬浮。将悬浮液嵌入移植物壁中，以将组织碎片截留在移植物壁的间隙中。所有移植物显示新生内膜愈合良好，整个移植物表面快速内皮化。由于脂肪组织可用于任何外科领域，因此在临床上有很大的应用价值。外周静脉组织含有动脉壁的主要细胞成分。因此，植入静脉组织碎片的移植物愈合良好。网膜组织显示非常活跃的细胞迁移和增殖。骨髓移植血管移植物作为一种自分泌的人工器官，产生生长因子，具有自我调节的功能。在一项犬研究中，采集自体骨髓，嵌入长纤维长度的ePTFE移植物壁中，并植入腹主动脉中。整个移植物同时开始活跃的内皮化，有许多毛细血管向内生长，并在3周内完成整个长度。移植的骨髓细胞存活并继续外源性造血，并合成bFGF，激活移植物壁的血管生成。一个完整的内皮细胞衬里和造血维持无不良反应长达6 months.From这些结果，我们得出结论，自体组织碎片移植物是有前途的候选人，冠状动脉搭桥手术。

We developed a new method to accelerate the healing process of neointima formation of fabric vascular prostheses using autologous tissue fragment transplantation technology. This technology was applied to develop a small diameter vascular prostheses for aorta-coronary bypass surgery. As the autologous tissue, we used peripheral venous tissue, omentum tissue, subcutaneous adipose tissue and bone marrow tissue were adopted in this study. These tissues were chopped up and suspended. The suspension was enmeshed into the graft wall to entrap the tissue fragments in the interstices of the graft wall. All the grafts showed excellent healing of neointima with rapid endothelialization throughout the graft surface. Adipose tissue was useful in clinic since it was available in any surgical fields. Peripheral venous tissue contained major cell component of arterial wall. Therefore, the graft seeded with venous tissue fragments showed good healing. Omentum tissue revealed very active cell migration and proliferation. Bone marrow tissue showed different and special healing process as follows.A bone marrow transplanted vascular graft functioned as an autocrine artificial organ which produced growth factors and was self-regulated. In a canine study, autologous bone marrow was harvested, enmeshed into a long-fibril-lenght ePTFE graft wall and implanted in the abdominal aorta. Active endothelialization started simultaneously throughout the graft, with numerous capillary ingrowth and was completed throughout the length within 3 weeks. Transplanted marrow cells survived and continued exogenous hemopoiesis with synthesis of bFGF which activated angiogenesis in the graft wall. A complete endothelial cell lining and hemopoiesis were maintained without adverse effects for up to 6 months.From these results, we concluded that the grafts with autologous tissue fragmentation were promising candidates for aorta-coronary bypass surgery.