A novel hybrid silk-fibroin/polyurethane three-layered vascular graft: Towards in situ tissue-engineered vascular accesses for haemodialysis

Sebastião van Uden, Noemi Vanerio, Valentina Catto, Barbara Bonandrini, Matteo Tironi, Marina Figliuzzi, Andrea Remuzzi, Linda Kock, Alberto C.L. Redaelli, Francesco G. Greco, Stefania A. Riboldi (Corresponding author)

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Clinically available alternatives of vascular access for long-term haemodialysis - currently limited to native arteriovenous fistulae and synthetic grafts - suffer from several drawbacks and are associated to high failure rates. Bioprosthetic grafts and tissue-engineered blood vessels are costly alternatives without clearly demonstrated increased performance. In situ tissue engineering could be the ideal approach to provide a vascular access that profits from the advantages of vascular grafts in the short-term (e.g. early cannulation) and of fistulae in the long-term (e.g. high success rates driven by biointegration). Hence, in this study a three-layered silk fibroin/polyurethane vascular graft was developed by electrospinning to be applied as long-term haemodialysis vascular access pursuing a 'hybrid' in situ engineering approach (i.e. based on a semi-degradable scaffold). This Silkothane ® graft was characterized concerning morphology, mechanics, physical properties, blood contact and vascular cell adhesion/viability. The full three-layered graft structure, influenced by the polyurethane presence, ensured mechanical properties that are a determinant factor for the success of a vascular access (e.g. vein-graft compliance matching). The Silkothane ® graft demonstrated early cannulation potential in line with self-sealing commercial synthetic arteriovenous grafts, and a degradability driven by enzymatic activity. Moreover, the fibroin-only layers and extracellular matrix-like morphology, presented by the graft, revealed to be crucial in providing a non-haemolytic character, long clotting time, and favourable adhesion of human umbilical vein endothelial cells with increasing viability after 3 and 7 d. Accordingly, the proposed approach may represent a step forward towards an in situ engineered hybrid vascular access with potentialities for vein-graft anastomosis stability, early cannulation, and biointegration.

LanguageEnglish
Article number025007
Pages025007
Number of pages18
JournalBiomedical Materials
Volume14
Issue number2
DOIs
StatePublished - 1 Mar 2019

Fingerprint

Fibroins
Polyurethanes
Silk
Grafts
Tissue
Cell adhesion
Endothelial cells
Blood vessels
Electrospinning
Tissue engineering
Scaffolds
Profitability
Mechanics
Blood
Adhesion

Keywords

  • early cannulation
  • electrospinning
  • fibroin
  • haemodialysis vascular access
  • hybrid vascular graft
  • in situ tissue engineering
  • polyurethane

Cite this

van Uden, S., Vanerio, N., Catto, V., Bonandrini, B., Tironi, M., Figliuzzi, M., ... Riboldi, S. A. (2019). A novel hybrid silk-fibroin/polyurethane three-layered vascular graft: Towards in situ tissue-engineered vascular accesses for haemodialysis. Biomedical Materials, 14(2), 025007. [025007]. DOI: 10.1088/1748-605X/aafc96
van Uden, Sebastião ; Vanerio, Noemi ; Catto, Valentina ; Bonandrini, Barbara ; Tironi, Matteo ; Figliuzzi, Marina ; Remuzzi, Andrea ; Kock, Linda ; Redaelli, Alberto C.L. ; Greco, Francesco G. ; Riboldi, Stefania A./ A novel hybrid silk-fibroin/polyurethane three-layered vascular graft : Towards in situ tissue-engineered vascular accesses for haemodialysis. In: Biomedical Materials. 2019 ; Vol. 14, No. 2. pp. 025007
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abstract = "Clinically available alternatives of vascular access for long-term haemodialysis - currently limited to native arteriovenous fistulae and synthetic grafts - suffer from several drawbacks and are associated to high failure rates. Bioprosthetic grafts and tissue-engineered blood vessels are costly alternatives without clearly demonstrated increased performance. In situ tissue engineering could be the ideal approach to provide a vascular access that profits from the advantages of vascular grafts in the short-term (e.g. early cannulation) and of fistulae in the long-term (e.g. high success rates driven by biointegration). Hence, in this study a three-layered silk fibroin/polyurethane vascular graft was developed by electrospinning to be applied as long-term haemodialysis vascular access pursuing a 'hybrid' in situ engineering approach (i.e. based on a semi-degradable scaffold). This Silkothane {\circledR} graft was characterized concerning morphology, mechanics, physical properties, blood contact and vascular cell adhesion/viability. The full three-layered graft structure, influenced by the polyurethane presence, ensured mechanical properties that are a determinant factor for the success of a vascular access (e.g. vein-graft compliance matching). The Silkothane {\circledR} graft demonstrated early cannulation potential in line with self-sealing commercial synthetic arteriovenous grafts, and a degradability driven by enzymatic activity. Moreover, the fibroin-only layers and extracellular matrix-like morphology, presented by the graft, revealed to be crucial in providing a non-haemolytic character, long clotting time, and favourable adhesion of human umbilical vein endothelial cells with increasing viability after 3 and 7 d. Accordingly, the proposed approach may represent a step forward towards an in situ engineered hybrid vascular access with potentialities for vein-graft anastomosis stability, early cannulation, and biointegration.",
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van Uden, S, Vanerio, N, Catto, V, Bonandrini, B, Tironi, M, Figliuzzi, M, Remuzzi, A, Kock, L, Redaelli, ACL, Greco, FG & Riboldi, SA 2019, 'A novel hybrid silk-fibroin/polyurethane three-layered vascular graft: Towards in situ tissue-engineered vascular accesses for haemodialysis' Biomedical Materials, vol. 14, no. 2, 025007, pp. 025007. DOI: 10.1088/1748-605X/aafc96

A novel hybrid silk-fibroin/polyurethane three-layered vascular graft : Towards in situ tissue-engineered vascular accesses for haemodialysis. / van Uden, Sebastião; Vanerio, Noemi; Catto, Valentina; Bonandrini, Barbara; Tironi, Matteo; Figliuzzi, Marina; Remuzzi, Andrea; Kock, Linda; Redaelli, Alberto C.L.; Greco, Francesco G.; Riboldi, Stefania A. (Corresponding author).

In: Biomedical Materials, Vol. 14, No. 2, 025007, 01.03.2019, p. 025007.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - A novel hybrid silk-fibroin/polyurethane three-layered vascular graft

T2 - Biomedical Materials

AU - van Uden,Sebastião

AU - Vanerio,Noemi

AU - Catto,Valentina

AU - Bonandrini,Barbara

AU - Tironi,Matteo

AU - Figliuzzi,Marina

AU - Remuzzi,Andrea

AU - Kock,Linda

AU - Redaelli,Alberto C.L.

AU - Greco,Francesco G.

AU - Riboldi,Stefania A.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Clinically available alternatives of vascular access for long-term haemodialysis - currently limited to native arteriovenous fistulae and synthetic grafts - suffer from several drawbacks and are associated to high failure rates. Bioprosthetic grafts and tissue-engineered blood vessels are costly alternatives without clearly demonstrated increased performance. In situ tissue engineering could be the ideal approach to provide a vascular access that profits from the advantages of vascular grafts in the short-term (e.g. early cannulation) and of fistulae in the long-term (e.g. high success rates driven by biointegration). Hence, in this study a three-layered silk fibroin/polyurethane vascular graft was developed by electrospinning to be applied as long-term haemodialysis vascular access pursuing a 'hybrid' in situ engineering approach (i.e. based on a semi-degradable scaffold). This Silkothane ® graft was characterized concerning morphology, mechanics, physical properties, blood contact and vascular cell adhesion/viability. The full three-layered graft structure, influenced by the polyurethane presence, ensured mechanical properties that are a determinant factor for the success of a vascular access (e.g. vein-graft compliance matching). The Silkothane ® graft demonstrated early cannulation potential in line with self-sealing commercial synthetic arteriovenous grafts, and a degradability driven by enzymatic activity. Moreover, the fibroin-only layers and extracellular matrix-like morphology, presented by the graft, revealed to be crucial in providing a non-haemolytic character, long clotting time, and favourable adhesion of human umbilical vein endothelial cells with increasing viability after 3 and 7 d. Accordingly, the proposed approach may represent a step forward towards an in situ engineered hybrid vascular access with potentialities for vein-graft anastomosis stability, early cannulation, and biointegration.

AB - Clinically available alternatives of vascular access for long-term haemodialysis - currently limited to native arteriovenous fistulae and synthetic grafts - suffer from several drawbacks and are associated to high failure rates. Bioprosthetic grafts and tissue-engineered blood vessels are costly alternatives without clearly demonstrated increased performance. In situ tissue engineering could be the ideal approach to provide a vascular access that profits from the advantages of vascular grafts in the short-term (e.g. early cannulation) and of fistulae in the long-term (e.g. high success rates driven by biointegration). Hence, in this study a three-layered silk fibroin/polyurethane vascular graft was developed by electrospinning to be applied as long-term haemodialysis vascular access pursuing a 'hybrid' in situ engineering approach (i.e. based on a semi-degradable scaffold). This Silkothane ® graft was characterized concerning morphology, mechanics, physical properties, blood contact and vascular cell adhesion/viability. The full three-layered graft structure, influenced by the polyurethane presence, ensured mechanical properties that are a determinant factor for the success of a vascular access (e.g. vein-graft compliance matching). The Silkothane ® graft demonstrated early cannulation potential in line with self-sealing commercial synthetic arteriovenous grafts, and a degradability driven by enzymatic activity. Moreover, the fibroin-only layers and extracellular matrix-like morphology, presented by the graft, revealed to be crucial in providing a non-haemolytic character, long clotting time, and favourable adhesion of human umbilical vein endothelial cells with increasing viability after 3 and 7 d. Accordingly, the proposed approach may represent a step forward towards an in situ engineered hybrid vascular access with potentialities for vein-graft anastomosis stability, early cannulation, and biointegration.

KW - early cannulation

KW - electrospinning

KW - fibroin

KW - haemodialysis vascular access

KW - hybrid vascular graft

KW - in situ tissue engineering

KW - polyurethane

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U2 - 10.1088/1748-605X/aafc96

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van Uden S, Vanerio N, Catto V, Bonandrini B, Tironi M, Figliuzzi M et al. A novel hybrid silk-fibroin/polyurethane three-layered vascular graft: Towards in situ tissue-engineered vascular accesses for haemodialysis. Biomedical Materials. 2019 Mar 1;14(2):025007. 025007. Available from, DOI: 10.1088/1748-605X/aafc96