Park P K, Jarrell B E, Williams S K, Carter T L, Rose D G, Martinez-Hernandez A, Carabasi R A
Department of Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.
J Vasc Surg. 1990 Mar;11(3):468-75.
The addition of an endothelial cell lining to a prosthetic vascular graft may reduce the thrombogenicity of the blood-contacting surface. An endothelialized mesoatrial graft was implanted in a patient with Budd-Chiari syndrome caused by a primary inferior vena caval leiomyosarcoma. During the initial surgery a Dacron vascular graft was preclotted with plasma and then lined with microvascular endothelial cells derived from the patient's subcutaneous adipose tissue. The patient did well initially but 9 months later required resection of a mechanical stricture of the graft that occurred as it passed beneath the costochondral junction. Grossly, the luminal surface of the resected graft was free of thrombus, with a smooth, glistening, white surface. Light microscopy demonstrated a surface layer of cells morphologically consistent with an endothelial cell monolayer, a subendothelial layer composed of extracellular matrix and spindle-shaped cells, and granulation tissue around the Dacron fabric. Immunohistochemistry and electron microscopy confirmed the presence of vascular endothelium on the luminal surface. This report documents the successful achievement of a human endothelial cell monolayer that persisted for 9 months in the midportion of a Dacron vascular graft.
在人工血管移植物上添加内皮细胞衬里可能会降低血液接触表面的血栓形成性。一名患有原发性下腔静脉平滑肌肉瘤所致布加综合征的患者植入了内皮化的中房移植物。在初次手术期间，用血浆预凝涤纶血管移植物，然后衬以源自患者皮下脂肪组织的微血管内皮细胞。患者最初情况良好，但9个月后需要切除移植物在肋软骨关节下方通过处出现的机械性狭窄。大体上，切除的移植物管腔表面无血栓，表面光滑、有光泽、呈白色。光学显微镜显示，表面有一层形态上与内皮细胞单层一致的细胞，其下方是由细胞外基质和梭形细胞组成的内皮下层，以及涤纶织物周围的肉芽组织。免疫组织化学和电子显微镜证实管腔表面存在血管内皮。本报告记录了在涤纶血管移植物中部成功形成持续9个月的人内皮细胞单层。
