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

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

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

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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