A multilayered electrospun graft as vascular access for hemodialysis

• Published in: PloS one Vol. 12; no. 10; p. e0185916
• Main Authors: Radakovic, D, Reboredo, J, Helm, M, Weigel, T, Schürlein, S, Kupczyk, E, Leyh, R G, Walles, H, Hansmann, J
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 12-10-2017; Public Library of Science (PLoS)
• Subjects: Antibiotics; Antimicrobial agents; Biofilms; Biology and Life Sciences; Bioreactors; Blood Vessel Prosthesis; Blood vessels; Caprolactone; Care and treatment; Cell adhesion & migration; Cell culture; Collagen; Collagen (type I); Collagen Type I - chemistry; Continuous flow; Diagnosis; Dialysis; Electron microscopy; Electrospinning; End-stage renal disease; Endothelial cells; Endothelial Cells - cytology; Endothelial Cells - metabolism; Endothelium; Environmental control; Fistulae; Gentamicin; Grafting; Grafts; Health aspects; Heart surgery; Hemodialysis; Hospitals; Humans; Kidney diseases; Kidney transplantation; Materials Testing; Mechanical properties; Medicine; Medicine and Health Sciences; Microvasculature; Morphology (Biology); Nanofibers; Nanofibers - chemistry; Physical Sciences; Polyesters - chemistry; Polymers; Prostheses; Renal Dialysis - instrumentation; Research and Analysis Methods; Robust control; Scanning electron microscopy; Shear stress; Staphylococcus aureus; Staphylococcus infections; Surgery; Thrombosis; Tissue engineering; Transplants & implants; Vancomycin; Vascular Access Devices; Vascular diseases; Veins & arteries; Venous access; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0185916

Despite medical achievements, the number of patients with end-stage kidney disease keeps steadily raising, thereby entailing a high number of surgical and interventional procedures to establish and maintain arteriovenous vascular access for hemodialysis. Due to vascular disease, aneurysms or infection, the preferred access-an autogenous arteriovenous fistula-is not always available and appropriate. Moreover, when replacing small diameter blood vessels, synthetic vascular grafts possess well-known disadvantages. A continuous multilayered gradient electrospinning was used to produce vascular grafts made of collagen type I nanofibers on luminal and adventitial graft side, and poly-ɛ-caprolactone as medial layer. Therefore, a custom-made electrospinner with robust environmental control was developed. The morphology of electrospun grafts was characterized by scanning electron microscopy and measurement of mechanical properties. Human microvascular endothelial cells were cultured in the graft under static culture conditions and compared to cultures obtained from dynamic continuous flow bioreactors. Immunofluorescent analysis showed that endothelial cells form a continuous luminal layer and functional characteristics were confirmed by uptake of acetylated low-density-lipoprotein. Incorporation of vancomycin and gentamicin to the medial graft layer allowed antimicrobial inhibition without exhibiting an adverse impact on cell viability. Most striking a physiological hemocompatibility was achieved for the multilayered grafts.