Coating with paclitaxel improves graft survival in a porcine model of haemodialysis graft stenosis.
BACKGROUND
Most commonly resulting from intimal hyperplasia at the venous anastomosis, stenosis leading to thrombosis is a major cause of failure of polytetrafluoroethylene (PTFE) dialysis grafts. We recently reported that coating haemodialysis grafts with paclitaxel could reduce neointimal hyperplasia. This study tested whether paclitaxel-coating could prolong graft survival in a porcine model.


METHODS
PTFE grafts were double-coated with paclitaxel. Bilateral grafts were created between the carotid arteries and the external jugular veins, and we evaluated graft survival by weekly measurements of blood flow for 12 weeks.


RESULTS
We successfully implanted four pairs of paclitaxel-coated grafts and four pairs of control grafts in eight Landrace pigs. One control pig had to be euthanized at 4 weeks after graft placement. The grafts in the other three controls and four paclitaxel pigs survived until harvesting of the grafts. All paclitaxel-coated grafts remained patent for 12 weeks without decrease of blood flow. Median blood flow was 702 ml/min at three weeks and 818 ml/min at 12 weeks after placement. In contrast, the four control grafts lost luminal patency at 5, 6, 6 and 8 weeks, respectively. In Kaplan-Meier analysis, paclitaxel-coated grafts showed better survival than uncoated grafts (P = 0.011).


CONCLUSIONS
Double-coating with paclitaxel improved graft survival. Coated PTFE grafts may be effective for the prevention of graft failure in patients on haemodialysis.
Lee
Byung Ha
BH
Division of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, Korea 135-710.
Lee
Jung Eun
JE
Lee
Kwang Woong
KW
Nam
Hye Yeong
HY
Jeon
Hyun Jung
HJ
Sung
Young Ju
YJ
Kim
Jong Sung
JS
Lim
Hyun Jung
HJ
Park
Jong-Sang
JS
Ko
Jai Young
JY
Kim
Dae Joong
DJ
D000818:Animals; D020099:Coated Materials, Biocompatible; D003251:Constriction, Pathologic; D004195:Disease Models, Animal; D006084:Graft Rejection; D006085:Graft Survival; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D011138:Polytetrafluoroethylene / Q000737:chemistry; D011474:Prosthesis Design; D006435:Renal Dialysis / Q000295:instrumentation*; D013552:Swine; D013997:Time Factors; D050257:Tubulin Modulators / Q000008:administration & dosage*
D020099:Coated Materials, Biocompatible; D050257:Tubulin Modulators; D011138:Polytetrafluoroethylene; D017239:Paclitaxel