Acellular Human Placenta Small-Diameter Vessels as a Favorable Source of Super-Microsurgical Vascular Replacements: A Proof of Concept

Abstract

In this study, we aimed to evaluate the human placenta as a source of blood vessels that can be harvested for vascular graft fabrication in the submillimeter range. Our approach included graft modification to prevent thrombotic events. Submillimeter arterial grafts harvested from the human placenta were decellularized and chemically crosslinked to heparin. Graft performance was evaluated using a microsurgical arteriovenous loop (AVL) model in Lewis rats. Specimens were evaluated through hematoxylin-eosin and CD31 staining of histological sections to analyze host cell immigration and vascular remodeling. Graft patency was determined 3 weeks after implantation using a vascular patency test, histology, and micro-computed tomography. A total of 14 human placenta submillimeter vessel grafts were successfully decellularized and implanted into AVLs in rats. An appropriate inner diameter to graft length ratio of 0.81 ± 0.16 mm to 7.72 ± 3.20 mm was achieved in all animals. Grafts were left in situ for a mean of 24 ± 4 days. Decellularized human placental grafts had an overall patency rate of 71% and elicited no apparent immunological responses. Histological staining revealed host cell immigration into the graft and re-endothelialization of the vessel luminal surface. This study demonstrates that decellularized vascular grafts from the human placenta have the potential to serve as super-microsurgical vascular replacements.

Replantation of multiple fingertip amputations using super microsurgery: A case report and literature review

“…(1) Since the first report on super microsurgery by Koshima in 1999, this technique has been widely used in both microsurgery 4 and lymphatic surgery. 5 The pipeline anastomosis with a diameter less than 0.8 mm can be classified into the field of super microsurgery, and the diameter of blood vessels in fingertip injuries is often less than 0.8 mm.…”

The journey of decellularized vessel: from laboratory to operating room

“…As for the physical methods, agitation or perfusion are efficient in facilitating contact of enzymes and detergents with tissues, even for sub-millimeter vessels such as the carotid artery of SD rats ( Wang et al, 2021 ) and the human placental artery. ( Falkner et al, 2023 ). When coming to evaluate the decellularization efficiency, histological analysis or DNA quantification were adopted.…”