Background Decellularization can reduce the immune response to aortic valve allograft tissue, but the thrombogenicity and in vivo remolding of these grafts remain controversial. The aim of the present study was to modify the surface of decellularized valvular conduits with heparin - stromal cell-derived factor-1α (SDF-1α) polyelectrolyte multilayer film and to test the thrombogenicity and biocompatibility in vitro and recellularization in vivo. Methods The donor aortic valvular conduits were decellularized with a combination of different detergents and were coated with heparin and SDF-1α alternately to form a polyelectrolyte multilayer. Platelet adhesion and lactate dehydrogenase assay were used to evaluate the antiplatelet property. The adhesion, growth, and migration of bone marrow stem cells (BMSCs) to the scaffolds were assessed. For in vivo studies, the grafts were anastomosed to the infrarenal aorta, without or with heparin and SDF-1α multilayer. Functional assessment was performed by Doppler echography and micro-computed tomography at 2-week and 4-week time points after implantation. Explanted grafts were examined histologically and by immunohistochemistry. Results In vitro studies demonstrated that the heparin-SDF-1α multilayer film improved hemocompatibility with respect to a substantial reduction of platelet adhesion. BMSCs also achieved better adhesion, proliferation, and migration on the modified graft. For in vivo studies, the grafts in both groups remained patent after 4 weeks, but it was demonstrated that the modified decellularized grafts had better self-endothelialization and recruitment of endothelial progenitor cells. Conclusions These results indicate that heparin-SDF-1α multilayer film can be used to cover the decellularized aortic valvular graft to decrease platelet adhesion while precipitating regeneration of the decellularized aortic valve allograft in vivo.
Zhou, J., Ye, X., Wang, Z., Liu, J., Zhang, B., Qiu, J., … Zhao, Q. (2015). Development of decellularized aortic valvular conduit coated by heparin-sdf-1α multilayer. Annals of Thoracic Surgery, 99(2), 612–618. https://doi.org/10.1016/j.athoracsur.2014.09.001