Zilla P, Preiss P, Groscurth P, Rösemeier F, Deutsch M, Odell J, Heidinger C, Fasol R, von Oppell U
Department of Cardio-Thoracic Surgery, University of Cape Town Medical School, South Africa.
Surgery. 1994 Sep;116(3):524-34.
The early fate of in vitro-endothelialized prosthetic vascular grafts was assessed in the nonhuman primate.
Each of 17 male chacma baboons received a control and a confluently endothelialized 4 mm polytetrafluoroethylene graft in femoro-femoral positions (8.2 +/- 0.8 cm). All experimental grafts were precoated with fibrinolytically inhibited fibrin glue and lined with cultured autologous endothelial cells (EC) from the external jugular vein. The average time period needed to obtain first-passage mass-cultures sufficient for preconfluent graft endothelialization was 19.8 +/- 5.2 days. Before implantation in vitro-lined grafts were kept in culture for another 16.1 +/- 4.3 days to achieve complete confluence and maturation of the EC cytoskeleton.
After 9 days of implantation, endothelial-lined grafts still showed a confluent endothelium that was free of any fibrin deposits. However, the EC density was significantly lower than at implantation (39.7 +/- 7.6 x 10(3) versus 59.9 +/- 8.5 x 10(3) EC/cm2; p < 0.05), and occasional 10-microns-wide intercellular gaps with adherent platelets and leukocytes were visible. Transmission electron microscopy showed leukocytes and cell debris in the underlying fibrin glue. After 4 weeks of implantation, the endothelium of experimental prostheses had regained a high cell density (72.7 +/- 10.5 x 10(3) EC/cm2) with a mature and well-differentiated morphologic appearance. At both observation periods, the surface of control grafts showed a wide range from fibrin deposits to an amorphous protein coverage containing spread platelets.
The endothelium of in vitro-endothelialized vascular prostheses remains confluent after implantation and is nonthrombogenic in spite of a moderate initial cell loss.
在非人灵长类动物中评估了体外内皮化人工血管移植物的早期转归。
17只雄性 chacma 狒狒，每只在股-股位置（8.2±0.8 cm）植入一个对照移植物和一个内皮细胞融合的4毫米聚四氟乙烯移植物。所有实验性移植物均预先用纤维蛋白溶解抑制的纤维蛋白胶包被，并内衬来自颈外静脉的培养自体内皮细胞（EC）。获得足以进行预融合移植物内皮化的首次传代大量培养所需的平均时间为19.8±5.2天。在植入前，体外内衬移植物在培养中再保存16.1±4.3天，以使EC细胞骨架完全融合和成熟。
植入9天后，内皮内衬移植物仍显示内皮细胞融合，无任何纤维蛋白沉积。然而，EC密度明显低于植入时（39.7±7.6×10³ 对59.9±8.5×10³ EC/cm²；p<0.05），可见偶尔有10微米宽的细胞间隙，伴有黏附的血小板和白细胞。透射电子显微镜显示在下面的纤维蛋白胶中有白细胞和细胞碎片。植入4周后，实验性假体的内皮细胞密度恢复到较高水平（72.7±10.5×10³ EC/cm²），形态成熟且分化良好。在两个观察期，对照移植物的表面从纤维蛋白沉积到含有铺展血小板的无定形蛋白质覆盖物范围广泛。
体外内皮化血管假体的内皮在植入后仍保持融合，尽管最初有适度的细胞丢失，但仍不形成血栓。
