Prostacyclin is produced from endothelial cell-seeded grafts: an experimental study in sheep

Endothelial cell seeding might be of value in reducing the thrombogenicity of small-diameter vascular grafts. We investigated the capacity of endothelial cell-seeded grafts to produce prostacyclin and compared this with that of the unseeded graft as well as the native artery. Twelve sheep were operated on with carotid interposition of externally supported knitted dacron grafts. On one side of the neck the graft was seeded with endothelial cells, enzymatically harvested from the left jugular vein. After 3 weeks, three out of 12 seeded grafts, and one out of 12 unseeded grafts were occluded (N.S.). After excision, the grafts were mounted and perfused ex vivo for five 15-min periods. During the last period, arachidonic acid (4 micrograms/ml) was added to the perfusate. The resected carotid artery was used as a control. Prostacyclin was determined as the stable degradation product 6-keto-PGF1 alpha using radio-immunoassay, and expressed as pg mm-2 luminal surface. The native artery had a significantly higher release of prostacyclin than the seeded graft, which in turn had a significantly higher release than the unseeded graft. Histological examination showed weakly positive staining for factor VIII-related antigen on the luminal surface of seeded grafts. Scanning electron microscopy showed endothelial cells with typical endothelial tufts and was evaluated blindly from 10 areas of each graft. The extent of endothelial cell coverage was evaluated and scored from 0 to 2.5. The median score for the unseeded grafts was 0.3 and for the seeded grafts 1.5 (p = 0.008). Prostacyclin production was higher in seeded than unseeded grafts, but did not influence patency in this model.