Improved patency of collagen-impregnated grafts after in vitro autogenous endothelial cell seeding

Currently available prosthetic vascular grafts remain sufficiently thrombogenic to preclude their use as small-caliber arterial substitutes. However, thrombogenicity may be significantly reduced by the presence of an endothelial monolayer on the luminal surface. The present study was undertaken to test the efficacy of lining a small-caliber prosthesis with autogenous endothelial cells in vitro so that the graft may subsequently be implanted with an established confluent endothelial lining. For this purpose, cells were obtained from canine external jugular vein, harvested enzymatically, and passaged in culture. Dacron grafts (4 X 150 mm) were then seeded in vitro and maintained for 48 to 72 hours before implantation in the femoral position of the same animal. Seeded grafts were implanted contralateral to unseeded control grafts and explanted after 1 month. Seeded grafts demonstrated an 86% patency rate at explanation in contrast to the significantly lower 14% patency rate of the unseeded control grafts. This study justifies further investigation directed toward the feasibility of endothelializing intravascular prostheses in vitro before implantation.