In vivo recellularization of xenogeneic vascular grafts decellularized with high hydrostatic pressure method in a porcine carotid arterial interpose model

• Published in: PloS one Vol. 16; no. 7; p. e0254160
• Main Authors: Kurokawa, Shunji, Hashimoto, Yoshihide, Funamoto, Seiichi, Murata, Kozue, Yamashita, Akitatsu, Yamazaki, Kazuhiro, Ikeda, Tadashi, Minatoya, Kenji, Kishida, Akio, Masumoto, Hidetoshi
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 22-07-2021; Public Library of Science (PLoS)
• Subjects: Actin; Aneurysm; Antiplatelet therapy; Arteries; Autografts; Bioengineering; Biology and Life Sciences; Biomedical materials; Blood vessels; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Carotid arteries; Carotid artery; Catheters; Collagen; Complications and side effects; Drying; Elastin; Electron microscopy; Endothelial cells; Endothelium; Engineering; Engineering and Technology; Extracellular matrix; Flow velocity; Grafting; Heart surgery; Hydrostatic pressure; Hyperplasia; Implantation; In vivo methods and tests; Laboratory animals; Medicine; Medicine and Health Sciences; Mortality; Muscles; Patient outcomes; Preservation; Research and Analysis Methods; Scanning electron microscopy; Smooth muscle; Stenosis; Surgery; Thromboembolism; Thrombosis; Ultrasonic imaging; Vascular grafts; Von Willebrand factor; Xenografts; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0254160

Autologous vascular grafts are widely used in revascularization surgeries for small caliber targets. However, the availability of autologous conduits might be limited due to prior surgeries or the quality of vessels. Xenogeneic decellularized vascular grafts from animals can potentially be a substitute of autologous vascular grafts. Decellularization with high hydrostatic pressure (HHP) is reported to highly preserve extracellular matrix (ECM), creating feasible conditions for recellularization and vascular remodeling after implantation. In the present study, we conducted xenogeneic implantation of HHP-decellularized bovine vascular grafts from dorsalis pedis arteries to porcine carotid arteries and posteriorly evaluated graft patency, ECM preservation and recellularization. Avoiding damage of the luminal surface of the grafts from drying significantly during the surgical procedure increased the graft patency at 4 weeks after implantation (P = 0.0079). After the technical improvement, all grafts (N = 5) were patent with mild stenosis due to intimal hyperplasia at 4 weeks after implantation. Neither aneurysmal change nor massive thrombosis was observed, even without administration of anticoagulants nor anti-platelet agents. Elastica van Gieson and Sirius-red stainings revealed fair preservation of ECM proteins including elastin and collagen after implantation. The luminal surface of the grafts were thoroughly covered with von Willebrand factor-positive endothelium. Scanning electron microscopy of the luminal surface of implanted grafts exhibited a cobblestone-like endothelial cell layer which is similar to native vascular endothelium. Recellularization of the tunica media with alpha-smooth muscle actin-positive smooth muscle cells was partly observed. Thus, we confirmed that HHP-decellularized grafts are feasible for xenogeneic implantation accompanied by recellularization by recipient cells.