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Bioengineered human acellular vessels recellularize and evolve into living blood vessels after human implantation.

Publication ,  Journal Article
Kirkton, RD; Santiago-Maysonet, M; Lawson, JH; Tente, WE; Dahl, SLM; Niklason, LE; Prichard, HL
Published in: Sci Transl Med
March 27, 2019

Traditional vascular grafts constructed from synthetic polymers or cadaveric human or animal tissues support the clinical need for readily available blood vessels, but often come with associated risks. Histopathological evaluation of these materials has shown adverse host cellular reactions and/or mechanical degradation due to insufficient or inappropriate matrix remodeling. We developed an investigational bioengineered human acellular vessel (HAV), which is currently being studied as a hemodialysis conduit in patients with end-stage renal disease. In rare cases, small samples of HAV were recovered during routine surgical interventions and used to examine the temporal and spatial pattern of the host cell response to the HAV after implantation, from 16 to 200 weeks. We observed a substantial influx of alpha smooth muscle actin (αSMA)-expressing cells into the HAV that progressively matured and circumferentially aligned in the HAV wall. These cells were supported by microvasculature initially formed by CD34+/CD31+ cells in the neoadventitia and later maintained by CD34-/CD31+ endothelial cells in the media and lumen of the HAV. Nestin+ progenitor cells differentiated into either αSMA+ or CD31+ cells and may contribute to early recellularization and self-repair of the HAV. A mesenchymal stem cell-like CD90+ progenitor cell population increased in number with duration of implantation. Our results suggest that host myogenic, endothelial, and progenitor cell repopulation of HAVs transforms these previously acellular vessels into functional multilayered living tissues that maintain blood transport and exhibit self-healing after cannulation injury, effectively rendering these vessels like the patient's own blood vessel.

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Published In

Sci Transl Med

DOI

EISSN

1946-6242

Publication Date

March 27, 2019

Volume

11

Issue

485

Location

United States

Related Subject Headings

  • Vascular Grafting
  • Vascular Access Devices
  • Translational Research, Biomedical
  • Tissue Scaffolds
  • Tissue Engineering
  • Stem Cells
  • Spatio-Temporal Analysis
  • Renal Dialysis
  • Neovascularization, Physiologic
  • Myocytes, Smooth Muscle
 

Citation

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Kirkton, R. D., Santiago-Maysonet, M., Lawson, J. H., Tente, W. E., Dahl, S. L. M., Niklason, L. E., & Prichard, H. L. (2019). Bioengineered human acellular vessels recellularize and evolve into living blood vessels after human implantation. Sci Transl Med, 11(485). https://doi.org/10.1126/scitranslmed.aau6934
Kirkton, Robert D., Maribel Santiago-Maysonet, Jeffrey H. Lawson, William E. Tente, Shannon L. M. Dahl, Laura E. Niklason, and Heather L. Prichard. “Bioengineered human acellular vessels recellularize and evolve into living blood vessels after human implantation.Sci Transl Med 11, no. 485 (March 27, 2019). https://doi.org/10.1126/scitranslmed.aau6934.
Kirkton RD, Santiago-Maysonet M, Lawson JH, Tente WE, Dahl SLM, Niklason LE, et al. Bioengineered human acellular vessels recellularize and evolve into living blood vessels after human implantation. Sci Transl Med. 2019 Mar 27;11(485).
Kirkton, Robert D., et al. “Bioengineered human acellular vessels recellularize and evolve into living blood vessels after human implantation.Sci Transl Med, vol. 11, no. 485, Mar. 2019. Pubmed, doi:10.1126/scitranslmed.aau6934.
Kirkton RD, Santiago-Maysonet M, Lawson JH, Tente WE, Dahl SLM, Niklason LE, Prichard HL. Bioengineered human acellular vessels recellularize and evolve into living blood vessels after human implantation. Sci Transl Med. 2019 Mar 27;11(485).

Published In

Sci Transl Med

DOI

EISSN

1946-6242

Publication Date

March 27, 2019

Volume

11

Issue

485

Location

United States

Related Subject Headings

  • Vascular Grafting
  • Vascular Access Devices
  • Translational Research, Biomedical
  • Tissue Scaffolds
  • Tissue Engineering
  • Stem Cells
  • Spatio-Temporal Analysis
  • Renal Dialysis
  • Neovascularization, Physiologic
  • Myocytes, Smooth Muscle