Differential outcomes of venous and arterial tissue engineered vascular grafts highlight the importance of coupling long-term implantation studies with computational modeling

Best, Cameron; Szafron, Jason M.; Rocco, Kevin A.; Zbinden, Jacob; Dean, Ethan W.; Maxfield, Mark W.; Kurobe, Hirotsugu; Tara, Shuhei; Bagi, Paul S.; Udelsman, Brooks V.; Khosravi, Ramak; Yi, Tai; Shinoka, Toshiharu; Humphrey, Jay D.; Breuer, Christopher K.

doi:10.1016/j.actbio.2019.05.063

Cited by 37 publications

(32 citation statements)

References 74 publications

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“…Indeed, previous computational simulations of short-term implants reinforced the importance of following the long-term performance of tissue engineered vascular grafts. [21,23] In a study, using electrospun scaffolds of poly--caprolactoneco-L-lactic acid fibers (PCLA), all arterial grafts experienced sudden dilation and rupture at 14 weeks due to the sudden loss of mechanical strength of the scaffolds and inadequate tissue formation. [21] A study utilizing an electrospun PGS scaffold reinforced with an external poly( -caprolactone) (PCL) sheath only showed vascular architecture after 12 months in vivo while still exhibiting high levels of inflammation due to the slowly degrading PCL sheath and small pore sizes for the inner PGS layer [23] Similar PGS-PCL scaffolds showed perioperative mortality of over 30% thought to be due to defects in the outer sheath and the for all groups except Design 3 coated which had n = 2).…”

Section: Discussionmentioning

confidence: 99%

“…While computational modeling offers a potential way to predict optimal scaffold parameters, improvements in fabrication methods with a high degree of control and replication will similarly be necessary to realize optimal designs. [17,21] Textile manufacturing offers a well-established method for producing scaffolds from a broad array of biodegradable polymers that can be fabricated with a wide range of mechanical properties. Textile manufacturing allows certain degrees of decoupling of the chemical and mechanical properties of the scaffold, enabling a wide range of mechanical properties using the same polymer yarn.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Braiding Parameters on Tissue Engineered Vascular Graft Development

Zbinden

Blum

Berman

et al. 2020

Adv Healthcare Materials

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Tissue engineered vascular grafts (TEVGs) using scaffolds fabricated from braided poly(glycolic acid) (PGA) fibers coated with poly(glycerol sebacate) (PGS) are developed. The approach relies on in vivo tissue engineering by which neotissue forms solely within the body after a scaffold has been implanted. Herein, the impact of altering scaffold braid design and scaffold coating on neotissue formation is investigated. Several combinations of braiding parameters are manufactured and evaluated in a Beige mouse model in the infrarenal abdominal aorta. Animals are followed with 4D ultrasound analysis, and 12 week explanted vessels are evaluated for biaxial mechanical properties as well as histological composition. Results show that scaffold parameters (i.e., braiding angle, braiding density, and presence of a PGS coating) have interdependent effects on the resulting graft performance, namely, alteration of these parameters influences levels of inflammation, extracellular matrix production, graft dilation, neovessel distensibility, and overall survival. Coupling carefully designed in vivo experimentation with regression analysis, critical relationships between the scaffold design and the resulting neotissue that enable induction of favorable cellular and extracellular composition in a controlled manner are uncovered. Such an approach provides a potential for fabricating scaffolds with a broad range of features and the potential to manufacture optimized TEVGs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Braiding Parameters on Tissue Engineered Vascular Graft Development

Zbinden

Blum

Berman

et al. 2020

Adv Healthcare Materials

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“…Active attempts have been made to develop new forms of vascular grafts using tissue engineering techniques. Decellularized scaffolds made using animal vessels and acellular platforms made using absorbable components are promising biomaterials for vascular substitutes [11][12][13], but further research and trials are needed before they can be applied in actual clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Hemashield Vascular Graft Is a Preferable Prosthetic Graft for Middle Hepatic Vein Reconstruction in Living Donor Liver Transplantation

Park

Hwang

et al. 2019

Ann Transplant

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BackgroundBecause of the supply shortage for homologous vein allografts, we previously used ringed Gore-Tex vascular grafts for middle hepatic vein (MHV) reconstruction in living donor liver transplantation. However, owing to the subsequent unavailability of ringed Gore-Tex grafts, we replaced them with Hemashield vascular grafts. This study aimed to compare the patency of Hemashield grafts with that of ringed Gore-Tex grafts.Material/MethodsThis was a retrospective double-arm study between the study group that used Hemashield grafts (n=63) and the historical control group that used ringed Gore-Tex grafts (n=126).ResultsIn the Gore-Tex and Hemashield groups, mean age was 53.1±6.2 and 54.3±10.4 years; model for end-stage liver disease score was 16.5±8.3 and 17.5±9.9; and graft-recipient weight ratio was 1.11±0.23 and 1.12±0.25, respectively. In the Gore-Tex graft group, V5 reconstruction was done in single (n=107, 84.9%), double (n=17, 13.5%), and none (n=2, 1.6%). V8 reconstruction was done in single (n=95, 75.4%), double (n=1, 0.8%), and none (n=30, 23.8%). In the Hemashield group, V5 reconstruction was done in single (n=43, 68.3%), double (n=19, 30.2%), and triple (n=1, 1.6%). V8 reconstruction was done in single (n=45, 71.4%), double (n=9, 14.3%), and none (n=9, 14.3%). One-year conduit patency rates in the Gore-Tex and Hemashield groups were 54.8% and 71.6%, respectively (p=0.048).ConclusionsMHV reconstruction using Hemashield vascular grafts demonstrated higher short-term patency rates than those associated with ringed Gore-Tex vascular grafts. We suggest that the Hemashield vascular graft is one of the best prosthetic materials for MHV reconstruction.

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“…De novo collagen formation in vivo and in vitro is a multifactorial mechanism still poorly understood where, given the same form of contact guidance and external mechanical cues, different outcomes can be dictated by scaffold mechanical properties ( 4 ) or native extracellular matrix microstructure. Conversely, different hemodynamic loads and anatomic positions (arterial vs. venous, carotid vs. abdominal aorta) are associated with dramatically different fates of the implants ( 5 ). The role of the host’s immunoresponse is pivotal, and mechanical stimuli on macrophages can have decisive consequences by inducing a specific phenotype.…”

mentioning

confidence: 99%

“…Contrary to studies on heart valves, which require large-animal models, other relevant studies on the effect of hemodynamic load conditions ( 5 ) and scaffold fiber alignment ( 4 ) on endogenous remodeling of vascular grafts could take advantage of a higher number of animals by using a more financially sustainable and logistically convenient model like the rat. Although this allows for more accurate statistical evaluation of the experimental results, it still needs to be considered that macrophages from different species differ in their phagocytic activity, chemotactic responsiveness and sensitivity, and even size, thus questioning the relevance of the preclinical models and their capacity to recapitulate human immune responses ( 6 ).…”

mentioning

confidence: 99%