Autologous glue: part of the sticky mystery unraveled.
OBJECTIVE
The aim of the study was to evaluate the safety and efficacy of an autologous surgical tissue adhesive.


METHODS
Autologous glue was made out of canine concentrated plasma proteins mixed with 7.5% glutaraldehyde. Tensile strength and cytotoxicity of the autologous glue were tested. In a dog model, 8 transectioned iliac arteries were reanastomosed by using the animal's glue as the sole fixation method. After 120 days, all animals were angiographically controlled for patency and killed for histologic and immunohistochemical examination of the anastomosis.


RESULTS
The autologous glue showed sufficient tensile strength (557 +/- 135 N/mm2). The elasticity of the glue is influenced by variations of concentrations in both proteins and glutaraldehyde. Glutaraldehyde remained cytotoxic, even at low concentrations of 2.5%. All operative procedures were successful. Angiographs performed before animal death showed all but 1 vessel to be patent and showed manifest compression signs in 3 anastomoses. Histological examination revealed only a foreign-body reaction adjacent to the surface of the glue. The autologous glue does not trigger any immune response on immunochemistry. Because fibroblastic neo-endothelial lining was near to normal, potential glutaraldehyde leaching does not seem too harmful for the vascular juncture in the dog model.


CONCLUSIONS
Autologous glutaraldehyde glue has been used successfully as a vascular adhesive. In contrast to our previous studies with heterologous glue, we did not find a fierce acute inflammatory reaction indicating immune triggering. Nevertheless, glutaraldehyde remains a cytotoxic cross-linker. It is yet not known whether autologous glutaraldehyde glue can be used safely in clinical practice.
Heart Center, University Hospital Ghent, Ghent, Belgium. guido.vannooten@UGent.be
Guido J
GJ
Van Nooten
Pamela
P
Somers
Ramses
R
Forsyth
Kishan
K
Narine
Yves
Y
Van Belleghem
Stefaan
S
Jacobs
Filip
F
De Somer
D000714:Anastomosis, Surgical; D000792:Angiography; D000818:Animals; D004285:Dogs; D004548:Elasticity; D005976:Glutaral / Q000633:toxicity; D007083:Iliac Artery / Q000601:surgery*; D008422:Materials Testing; D013718:Tensile Strength; D014014:Tissue Adhesives / Q000494:pharmacology*; D014654:Vascular Patency; D014945:Wound Healing
D014014:Tissue Adhesives; D005976:Glutaral