Tissue engineering applications to vascular bypass graft development: the use of adipose-derived stem cells

The burgeoning field of vascular tissue engineering holds promise for the creation of a practical and successful small-diameter arterial bypass graft. Many creative combinations of autologous cells and scaffolds exist along with an equally long list of microenvironmental cues used to create a functional arterial conduit. This review outlines our work using abdominal wall fat as a source of autologous stem cells for vascular tissue engineering, focusing specifically on this stem cell's availability and potency to differentiate into endothelial-like cells. In a series of 49 patients undergoing elective peripheral vascular surgery, an abundant quantity of adult stem cells was harvested from fat obtained by liposuction. The efficacy of the isolation did not appear influenced by advanced age, obesity, renal failure, or vascular disease, although fat from diabetic patients yielded significantly less stem cells. In addition, these adipose-derived stem cells acquired several morphologic and molecular endothelial phenotypes when exposed to growth factors (endothelial cell growth supplement and vascular endothelial growth factor) and physiologic shear stress in vitro. Taken together, these studies suggest that fat appears to be a viable source of autologous stem cells for use in vascular tissue engineering.