Effect of preclotting and precoating agents on seeded venous grafts

This study evaluated the effect of whole blood preclotting (WB), fibronectin (FB) and "Cell Tak" (CT) precoating on the patency rate of seeded vena cava grafts. Ten cm x 8 mm ID ringed PTFE grafts were implanted in the vena-cavae of 29 dogs. Aspirin (325 mg po qd) was administered pre-operatively and continued post-operatively. After preclotting or precoating, all grafts were seeded with porcine endothelial cells. The 32 day patency rates were: 67%, 67% and 37% for WB, FB and CT, respectively (p less than 0.5 CT vs FB, WB). Endothelialized surfaces ranged from 67 +/- 35, 43 +/- 41 to 28 +/- 45% respectively for WB, FB and CT (p less than 0.05 CT vs WB). Preclotting time was shortest for WB technique. We conclude that: 1) FB and WB grafts have the highest patency rate with WB preclotting being a more cost effective and less time consuming technique; 2) endothelial seeding and Aspirin may make vena cava grafting possible.