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Geelhoed WJ, van der Bogt KEA, Rothuizen TC, Damanik FFR, Hamming JF, Mota CD, van Agen MS, de Boer HC, Restrepo MT, Hinz B, Kislaya A, Poelma C, van Zonneveld AJ, Rabelink TJ, Moroni L, Rotmans JI. A novel method for engineering autologous non-thrombogenic in situ tissue-engineered blood vessels for arteriovenous grafting. Biomaterials 2019; 229:119577. [PMID: 31704466 DOI: 10.1016/j.biomaterials.2019.119577] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 10/14/2019] [Accepted: 10/22/2019] [Indexed: 12/15/2022]
Abstract
The durability of prosthetic arteriovenous (AV) grafts for hemodialysis access is low, predominantly due to stenotic lesions in the venous outflow tract and infectious complications. Tissue engineered blood vessels (TEBVs) might offer a tailor-made autologous alternative for prosthetic grafts. We have designed a method in which TEBVs are grown in vivo, by utilizing the foreign body response to subcutaneously implanted polymeric rods in goats, resulting in the formation of an autologous fibrocellular tissue capsule (TC). One month after implantation, the polymeric rod is extracted, whereupon TCs (length 6 cm, diameter 6.8 mm) were grafted as arteriovenous conduit between the carotid artery and jugular vein of the same goats. At time of grafting, the TCs were shown to have sufficient mechanical strength in terms of bursting pressure (2382 ± 129 mmHg), and suture retention strength (SRS: 1.97 ± 0.49 N). The AV grafts were harvested at 1 or 2 months after grafting. In an ex vivo whole blood perfusion system, the lumen of the vascular grafts was shown to be less thrombogenic compared to the initial TCs and ePTFE grafts. At 8 weeks after grafting, the entire graft was covered with an endothelial layer and abundant elastin expression was present throughout the graft. Patency at 1 and 2 months was comparable with ePTFE AV-grafts. In conclusion, we demonstrate the remodeling capacity of cellularized in vivo engineered TEBVs, and their potential as autologous alternative for prosthetic vascular grafts.
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Affiliation(s)
- W J Geelhoed
- Department of Internal Medicine, Leiden University Medical Center, the Netherlands; Einthoven Laboratory of Vascular and Regenerative Medicine, the Netherlands
| | - K E A van der Bogt
- Department of Surgery, Leiden University Medical Center, the Netherlands
| | - T C Rothuizen
- Department of Internal Medicine, Leiden University Medical Center, the Netherlands
| | - F F R Damanik
- MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, the Netherlands
| | - J F Hamming
- Department of Surgery, Leiden University Medical Center, the Netherlands
| | - C D Mota
- MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, the Netherlands
| | - M S van Agen
- Department of Internal Medicine, Leiden University Medical Center, the Netherlands; Einthoven Laboratory of Vascular and Regenerative Medicine, the Netherlands
| | - H C de Boer
- Department of Internal Medicine, Leiden University Medical Center, the Netherlands; Einthoven Laboratory of Vascular and Regenerative Medicine, the Netherlands
| | - M Tobón Restrepo
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - B Hinz
- Laboratory of Tissue Repair and Regeneration, Faculty of Dentistry, University of Toronto, Canada
| | - A Kislaya
- Laboratory for Aero and Hydrodynamics, Delft University of Technology, Delft, the Netherlands
| | - C Poelma
- Laboratory for Aero and Hydrodynamics, Delft University of Technology, Delft, the Netherlands
| | - A J van Zonneveld
- Department of Internal Medicine, Leiden University Medical Center, the Netherlands; Einthoven Laboratory of Vascular and Regenerative Medicine, the Netherlands
| | - T J Rabelink
- Department of Internal Medicine, Leiden University Medical Center, the Netherlands
| | - L Moroni
- MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, the Netherlands
| | - J I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, the Netherlands.
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Wong CY, Rothuizen TC, de Vries MR, Rabelink TJ, Hamming JF, van Zonneveld AJ, Quax PHA, Rotmans JI. Elastin is a key regulator of outward remodeling in arteriovenous fistulas. Eur J Vasc Endovasc Surg 2015; 49:480-6. [PMID: 25701072 DOI: 10.1016/j.ejvs.2014.12.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/15/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Maturation failure is the major limitation of arteriovenous fistulas (AVFs) as hemodialysis access conduits. Indeed, 30-50% of AVFs fail to mature due to intimal hyperplasia and insufficient outward remodeling. Elastin has emerged as an important determinant of vascular remodeling. Here the role of elastin in AVF remodeling in elastin haplodeficient (eln(+/-)) mice undergoing AVF surgery has been studied. METHODS Unilateral AVFs between the branch of the jugular vein and carotid artery in an end to side manner were created in wild-type (WT) C57BL/6 (n = 11) and in eln(+/-) mice (n = 9). Animals were killed at day 21 and the AVFs were analyzed histologically and at an mRNA level using real-time quantitative polymerase chain reaction. RESULTS Before AVF surgery, a marked reduction in elastin density in the internal elastic lamina (IEL) of eln(+/-) mice was observed. AVF surgery resulted in fragmentation of the venous internal elastic lamina in both groups while the expression of the tropoelastin mRNA was 53% lower in the eln(+/-) mice than in WT mice (p < .001). At 21 days after AVF surgery, the circumference of the venous outflow tract of the AVF was 21% larger in the eln(+/-) mice than in the WT mice (p = .037), indicating enhanced outward remodeling in the eln(+/-) mice. No significant difference in intimal hyperplasia was observed. The venous lumen of the AVF in the eln(+/-) mice was 53% larger than in the WT mice, although this difference was not statistically significant (eln(+/-), 350,116 ± 45,073 μm(2); WT, 229,405 ± 40,453 μm(2); p = .064). CONCLUSIONS In a murine model, elastin has an important role in vascular remodeling following AVF creation, in which a lower amount of elastin results in enhanced outward remodeling. Interventions targeting elastin degradation might be a viable option in order to improve AVF maturation.
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Affiliation(s)
- C Y Wong
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands
| | - T C Rothuizen
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands
| | - M R de Vries
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - T J Rabelink
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands
| | - J F Hamming
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - A J van Zonneveld
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands
| | - P H A Quax
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - J I Rotmans
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden Medical Center, Leiden, The Netherlands.
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Rothuizen TC, Ocak G, Verschuren JJ, Dekker FW, Rabelink TJ, Jukema JW, Rotmans JI, Silva V, Raimann JG, Grassmann A, Marcelli D, Usvyat L, Canaud B, Kotanko P, Pecoits-Filho R, Consortium M, Strippoli GF, Sue YM, Tang CH, Chen TH, Hong CY, Ochi A, Ishimura E, Masuda M, Tsujimoto Y, Okuno S, Tabata T, Nishizawa Y, Inaba M, Moon Ki H, Do Hyoung K, Min Jee H, Hyun K, Wang Soo L, Su-Hyun K, Selim G, Stojceva-Taneva O, Tozija L, Dzekova-Vidimliski P, Trajceska L, Gelev S, Amitov V, Petronievic Z, Sikole A, Kee YK, Kim YL, Han JH, Oh HJ, Park JT, Han SH, Yoo TH, Kang SW, Okute Y, Shoji T, Sonoda M, Kuwamura Y, Tsujimoto Y, Tabata T, Shioi A, Tahara H, Emoto M, Inaba M, El Amrani M, Asserraji M, Benyahia M, Galloway PA, Yiu V, Hiemstra TF, Nilssen C, Zannad F, Jardine A, Schmieder R, Fellstrom B, Holdaas H, Mjoen G, Eftimovska - Otovic N, Babalj - Banskolieva E, Bogdanoska - Kostadinoska S, Grozdanovski R, Silva BC, Freitas GR, Silva VB, Abensur H, Luders C, Pereira BJ, Castro MC, Oliveira RB, Moyses RM, Elias RM, Perez De Jose A, Abad S, Vega A, Reque J, Quiroga B, Lopez-Gomez JM, Sasaki K, Yamguchi K, Hesaka A, Iwahashi E, Sakai S, Fujimoto T, Minami S, Fujita Y, Yokoyama K, Kidir V, Ersoy I, Altuntas A, Inal S, Do an A, Sezer MT, Azar H, Chacra D, Dabar G, Chelala D, Zhao L, Huang S, Liang T, Tang H, Turkmen K, Demirtas L, Akbas EM, Buyuklu M, Bakirci E, Kocyigit I, Ozcelik O, Guney I, Mumajesi S, Velaj A, Idrizi A, Pasko N, Cadri V, Barbullushi M, Bolleku E, Strakosh A, Cenaj A, Kacori V, Zekollari E, Rista E, Dusha D, Belba A, Thereska N, Gelev S, Toshev S, Trajceska L, Pavleska S, Selim G, Dzekova P, Shikole A, Naess H, Fellstrom B, Jardine AG, Schmieder RE, Zannad F, Holdaas H, Mjoen G, Sasaki K, Yamguchi S, Hesaka A, Iwahashi E, Sakai S, Fujimoto T, Minami S, Fujita Y, Yokoyama K, Bilevich O, Bunova S, Semchenko S, Schwermer K, Hoppe K, Klysz P, Baum E, Sikorska D, Radziszewska D, Sawatiuk P, Olejniczak P, Pawlaczyk K, Lindholm B, Oko A, El Amrani M, Asserraji M, Rbaibi A, El Kharass A, Benyahia M, Rroji ( Molla) M, Seferi S, Cafka M, Spahia N, Likaj E, Thereska N, Barbullushi M, Pelletier CC, Jolivot A, Kalbacher E, Panaye M, Bureau Du Colombier P, Juillard L, Burmeister JE, Mosmann CB, Bastos JP, Burmeister BO, Munaro G, Pereira JD, Youssef DW, Rosito GA. DIALYSIS CARDIOVASCULAR COMPLICATIONS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fontsere N, Mestres G, Burrel M, Barrufet M, Montana X, Arias M, Ojeda R, Maduell F, Campistol JM, Nagaraja P, Rees D, Husein T, Chess J, Lin CC, Yang WC, Khosravi M, Kandil H, Cross J, Hopkins S, Collier S, Lopes D, Pereira S, Gomes AM, Ventura A, Martins V, Seabra J, Rothuizen TC, Damanik F, Visser MJT, Lavrijsen T, Cox MAJ, Moroni L, Rabelink TJ, Rotmans JI, Fontsere N, Cardozo C, Donate J, Soriano A, Muros M, Pons M, Mensa J, Campistol JM, Navarro-Gonzalez JF, Maduell F, Wijewardane A, Murley A, Powers S, Allen C, Baharani J, Wilmink T, Esenturk M, Zengin M, Dal M, Tahtal N, Shibata K, Shinzato T, Satta H, Nishihara M, Koguchi N, Kuji T, Kawata S, Kaneda T, Yasuda G, Scrivano J, Pettorini L, Rutigliano T, Ciavarella GM, De Biase L, Punzo G, Mene P, Pirozzi N, El Haggan W, Belazrague K, Ehoussou S, Foucher V, El Salhy M, Ouellet G, Davis J, Caron P, Leblanc M, Pettorini L, Romitelli F, Fazzari L, Scrivano J, Ortu G, Di Stasio E, Punzo G, Mene P, Pirozzi N, Loizzo G, Vigano SM, Bacchini G, Rocchi E, Sala V, Pontoriero G, Letachowicz K, Go biowski T, Kusztal M, Letachowicz W, Weyde W, Klinger M, Murley A, Wijewardane A, Powers S, Allen C, Hollingsworth L, Wilmink T, Baharani J, Roca-Tey R, Samon R, Ibrik O, Roda A, Gonzalez-Oliva JC, Martinez-Cercos R, Viladoms J, Renaud CJ, Lim EK, Seow TY, Teh HS, Tosic J, Jankovic A, Djuric P, Radovic Maslarevic V, Popovic J, Dimkovic N, Kazantzi A, Trigka K, Buono F, Laurino S, Toriello G, Di Luccio R, Galise A, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Asano M, Oguchi K, Saito A, Onishi Y, Yamamoto Y, Fukuhara S, Akiba T, Akizawa T, Kurokawa K, Guedes Marques M, Ibeas J, Maia P, Ponce P, Chang KY, Park HS, Kim HW, Choi BS, Park CW, Yang CW, Jin DC, Likaj E, Seferi S, Caco G, Petrela E, Barbullushi M, Idrizi A, Thereska N, Lomonte C, Casucci F, Libutti P, Lisi P, Basile C, Ancarani P, Valsuani G, Cavallo L, Parodi D, Lorusso C, Renaud C, Lai BC, Tho S, Yeoh L, Guedes Marques M, Botelho C, Maia P, Ponce P, Yankovoy A, Alexandr S, Smoliacov A, Stepanov V, Rees D, Parker C, Davies P, Taylor S, Mikhail A, Kim YO, Yoon SA, Kim YS, Choi SJ, Min JW, Cheong MA, Gubensek J, Persic V, Vajdic B, Ponikvar R, Buturovic-Ponikvar J, Hadimeri U, Warme AV, Stegmayr B, Jankovic A, Suvakov S, Tosic J, Damjanovic T, Djuric P, Bajcetic S, Radovic-Maslarevic V, Popovic J, Simic T, Dimkovic N, Likaj E, Seferi S, Petrela E, Idrizi A, Rroji M, Barbullushi M, Thereska N, Chua HL, Kanda H, See SL, Liew NC, Tsuchida K, Tomo T, Fukasawa M, Kawashima S, Minakuchi J, Thanaraj V, Dhaygude A, Ikeda K, Forneris G, Cecere P, Pozzato M, Trogolo M, Vallero A, Mesiano P, Roccatello D, Esenturk M, Zengin M, Keskin L, Loizzo G, Vigano SM, Bacchini G, Rocchi E, Sala V, Pontoriero G, Casey JR, Hanson CS, Winkelmayer WC, Craig J, Palmer S, Strippoli G, Tong A, Ferrara D, Scamarda S, Bernardino L, Amico L, Lorito MC, Incalcaterra F, Visconti L, Visconti G, Valenza F, D'Amato F, Di Napoli A, Tazza L, Chicca S, Lapucci E, Silvestri P, Di Lallo D, Michelozzi P, Davoli M. DIALYSIS VASCULAR ACCESS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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