Fibroblast and vascular endothelial growth factor coating of decellularized vascular grafts stimulates undesired giant cells and graft encapsulation in a rat model.
Replacing an infected prosthesis with a bioimplant provides a hopeful alternative in septic vascular surgery. The objective of this study was to determine the effect of fibroblast endothelial growth factors (FGF) and vascular endothelial growth factors (VEGF) coating on a decellularized vascular graft in a rat model and the possible impact on recellularization processes. Rat aortas were decellularized, crosslinked with genipin, and coated with poly-(D, L) lactide containing either FGF or VEGF. Observation periods were 6 and 12 weeks. Surprisingly, we found moderate accumulation of giant cells around the grafts that contained poly-(D, L) lactide acid. FGF and VEGF grafts showed massive stimulation of giant cells and eosinophils leading to complete graft encapsulation (P < 0.05). Pseudointmal hyperplasia was significantly increased in the FGF group (P < 0.05). Both results can only be interpreted as very negative. We achieved a situation in diametric opposition to that which we had hoped for. These data demonstrate that the use of growth factors may produce harmful side effects.
Heidenhain
Christoph
C
Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow, University Medicine Berlin, Berlin, Germany. christoph.heidenhain@charite.de
Veeravoorn
Ariyakhagorn
A
Vachkov
Blagovest
B
Weichert
Wilko
W
Schmidmaier
Gerhard
G
Wildemann
Britt
B
Neuhaus
Peter
P
Heise
Michael
M
D000818:Animals; D001011:Aorta / Q000601:surgery / Q000648:ultrastructure; D001807:Blood Vessel Prosthesis; D020099:Coated Materials, Biocompatible / Q000378:metabolism*; D005346:Fibroblast Growth Factors / Q000378:metabolism*; D015726:Giant Cells / Q000166:cytology / Q000378:metabolism; D018919:Neovascularization, Physiologic; D051381:Rats; D017208:Rats, Wistar; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D058017:Vascular Grafting; D014654:Vascular Patency
D020099:Coated Materials, Biocompatible; D042461:Vascular Endothelial Growth Factor A; D005346:Fibroblast Growth Factors