Biological vascular grafts for hemodialysis access

Abstract

Evaluation of: Tillman BW, Yazdani SK, Neff LP et al. Bioengineered vascular access maintains structural integrity in response to arteriovenous flow and repeated needle puncture. J. Vasc. Surg. 56(3), 783–793 (2012).

Alternatives to autogenous arteriovenous hemodialysis (HD) access, such as synthetic arteriovenous bypass grafts and central venous catheters, are associated with a higher rate of complications. The evaluated article assessed the repeated cannulation challenges of HD in tissue-engineered blood vessels implanted in a bovine in vivo model (n = 15). Two groups were studied. A short-term group in which the graft was explanted and histologically examined (n = 7) and a second group in which the graft was left in for 6 months or until outflow venous stenosis occurred (n = 8). Two grafts from each group occluded 1-month postoperatively. Of the 11 remaining, cannulation was well tolerated with adequate hemostasis. Histological analysis demonstrated host cell repopulation of the outer surface in the short-term group (n = 5) and stable wall geometry in the long-term group. The authors concluded that their study proves the concept of using a scaffold-based approach to tissue-engineered blood vessels for HD access.

Keywords::

• arteriovenous
• biosynthetic graft
• endothelial progenitor cells
• hemodialysis
• tissue-engineered blood vessel
• vascular access

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.