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<p>The sustainability of vascular access for hemodialysis is limited by frequent interventions and the inability of synthetic grafts to self-heal. Tissue engineering offers a solution through biodegradable grafts that remodel into autologous tissue. Here we assess electrospun polycarbonate-bis urea (PC-BU) vascular scaffolds (6mm-inner-Ø), reinforced with 3D-printed polycaprolactone coils, in a goat model, and compared them to expanded polytetrafluoroethylene (ePTFE) controls. The tissue-engineered grafts were repeatedly cannulated starting two weeks after implantation and were evaluated using computed tomography and histological analyses. By 12 weeks, the PC-BU grafts remodel into autologous tissue while maintaining structural integrity, maintaining integrity without dilations, ruptures, or aneurysms. Cannulation does not interfere with scaffold degradation or neo-tissue formation. Although the patency rate is lower for the PC-BU grafts (50%) compared to ePTFE (100%), the engineered grafts exhibit a self-healing response not seen in ePTFE. These findings demonstrate the potential of PC-BU tissue-engineered grafts as healing, functional vascular access solutions for hemodialysis, supporting cannulation during tissue transformation.</p>

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Evaluation of in situ tissue-engineered arteriovenous grafts suitable for cannulation in a large animal model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月16日

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  • Paul J. Besseling,
  • Wojciech Szymczyk,
  • Martin Teraa,
  • Raechel J. Toorop,
  • Paul. A. A. Bartels,
  • Boris Arts,
  • Rob C. H. Driessen,
  • Arturo M. Lichauco,
  • Hidde C. Bakker,
  • Joost O. Fledderus,
  • Gert J. de Borst,
  • Patricia Y. W. Dankers,
  • Carlijn V. C. Bouten,
  • Marianne C. Verhaar

摘要

The sustainability of vascular access for hemodialysis is limited by frequent interventions and the inability of synthetic grafts to self-heal. Tissue engineering offers a solution through biodegradable grafts that remodel into autologous tissue. Here we assess electrospun polycarbonate-bis urea (PC-BU) vascular scaffolds (6mm-inner-Ø), reinforced with 3D-printed polycaprolactone coils, in a goat model, and compared them to expanded polytetrafluoroethylene (ePTFE) controls. The tissue-engineered grafts were repeatedly cannulated starting two weeks after implantation and were evaluated using computed tomography and histological analyses. By 12 weeks, the PC-BU grafts remodel into autologous tissue while maintaining structural integrity, maintaining integrity without dilations, ruptures, or aneurysms. Cannulation does not interfere with scaffold degradation or neo-tissue formation. Although the patency rate is lower for the PC-BU grafts (50%) compared to ePTFE (100%), the engineered grafts exhibit a self-healing response not seen in ePTFE. These findings demonstrate the potential of PC-BU tissue-engineered grafts as healing, functional vascular access solutions for hemodialysis, supporting cannulation during tissue transformation.