Division of Transplant and Vascular Surgery, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.
Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Korea.
Ann Biomed Eng. 2019 Apr;47(4):1063-1077. doi: 10.1007/s10439-019-02212-5. Epub 2019 Jan 24.
An absorbable vascular anastomosis device (AVAD) was fabricated and tested in pig liver transplantation experiments. We prepared biodegradable copolymers with various ratios of L-lactide: glycolide and tested their properties including inherent viscosity, in vitro biodegradation, and tensile strength. The mechanical and physical properties of the finally selected copolymers were analyzed according to decomposition time. The AVAD, consisting of two inner rings and one coupler, was fabricated with 5-, 15-, and 20-mm diameter sizes using an injection molding machine. Based on changes in the overall mechanical and physical properties, it is believed that the AVAD will maintain its shape without deformation while connecting the blood vessels to external force for at least 3 weeks. Four mini-pigs underwent liver transplantation with AVAD using livers obtained from swine leukocyte antigen-identical siblings. Anastomoses was achieved in all four cases. In case 4, an autopsy conducted at 4 months revealed that the AVAD was absorbed and the anastomosis was intact, demonstrating the success of the AVAD in the pig liver transplantation experiments and the feasibility of using an AVAD in organ transplantation.
一种可吸收血管吻合装置(AVAD)已被制备并在猪肝移植实验中进行了测试。我们用不同比例的 L-丙交酯:乙交酯合成了可生物降解的共聚物,并测试了它们的特性,包括特性粘度、体外生物降解性和拉伸强度。最后根据分解时间分析了选定共聚物的机械和物理性能。AVAD 由两个内圈和一个耦合器组成,使用注塑机制造了 5、15 和 20mm 直径的尺寸。根据整体机械和物理性能的变化,我们相信 AVAD 在连接血管和外力时,至少在 3 周内将保持其形状而不会变形。四只小型猪接受了来自猪白细胞抗原相同的供体的肝脏的 AVAD 肝移植。在所有四个病例中均成功进行了吻合。在第 4 例中,4 个月的尸检显示 AVAD 已被吸收,吻合口完整,这表明 AVAD 在猪肝移植实验中取得了成功,以及在器官移植中使用 AVAD 的可行性。