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.
| Original language | English |
|---|---|
| Article number | 025007 |
| Pages (from-to) | 025007 |
| Number of pages | 18 |
| Journal | Biomedical Materials |
| Volume | 14 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Mar 2019 |
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Keywords
- early cannulation
- electrospinning
- fibroin
- haemodialysis vascular access
- hybrid vascular graft
- in situ tissue engineering
- polyurethane
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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 journal › Article › Academic › peer-review
TY - JOUR
T1 - A novel hybrid silk-fibroin/polyurethane three-layered vascular graft
T2 - Towards in situ tissue-engineered vascular accesses for haemodialysis
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
UR - http://www.scopus.com/inward/record.url?scp=85060781530&partnerID=8YFLogxK
U2 - 10.1088/1748-605X/aafc96
DO - 10.1088/1748-605X/aafc96
M3 - Article
C2 - 30620939
VL - 14
SP - 025007
JO - Biomedical Materials
JF - Biomedical Materials
SN - 1748-6041
IS - 2
M1 - 025007
ER -