Cell seeded decellularised allogeneic matrix grafts and biodegradable polydioxanone-prostheses compared with arterial autografts in a porcine model

Abstract

Background: small diameter vascular grafts are limited by their restricted availability, early thrombosis, and requirement for anticoagulants. Objective: to evaluate different approaches to biocompatible vascular grafts. Methods: sixteen allogeneic acellularised arteries seeded with autologous endothelial cells were implanted to replace a segment of the common carotid artery (group I). Other animals received polydioxanone prostheses (group II: inner diameter, i.d. 4 mm, n = 18; group III, i.d. 5 mm, n = 20) or arterial autografts (group IV, n = 8). Graft patency was evaluated by means of ultrasound duplex scanning, angiography and histology. Results: patency was 54% (71%), 17% (0%), 50% (50%), and 100% (100%) in group I, II, III, and IV after 1 week (4 months), respectively. Significant differences (p<0.05) were found for group IV versus all other groups at 1 week, as well as for group IV versus groups II and III, for group II versus III, and group I versus II at 4 months. Conclusion: small diameter vascular grafts can be engineered from an acellular allogeneic matrix seeded with autologous cells. Patency is superior to polydioxanone prostheses but inferior to the arterial autograft.