Decellularization of human iliac artery: A vascular scaffold for peripheral repairs with human mesenchymal cells

This work presents strong evidence supporting the use of decellularized human iliac arteries combined with adipose tissue-derived stem cells (hASCs) as a promising alternative for vascular tissue engineering, opening the path to future treatments for peripheral artery disease (PAD). PAD is a progressive condition with high rates of amputation and mortality due to ischemic damage and limited graft options. Traditional synthetic grafts often fail due to poor integration, while autologous grafts may be unsuitable for patients with compromised vascular health. This study explores the potential of decellularized human iliac arteries as scaffolds for vascular grafts, focusing on preserving extracellular matrix (ECM) ultrastructure while minimizing immunogenic response. A perfusion-based protocol with enzymatic and detergent agents effectively removed cellular material, resulting in scaffolds with preserved ECM architecture, including organized collagen and elastin fibers. To assess scaffold bioactivity, hASCs were seeded onto the decellularized ECM, demonstrating high viability. Structural assessments, including histological staining and mechanical testing, confirmed that decellularized arteries retained their hierarchical structure and exhibited increased stiffness, suggesting an adaptive realignment of ECM fibers. Thermal and ultrastructural analyses further showed that decellularized scaffolds maintained stability and integrity comparable to native tissue, underscoring their durability for clinical applications. The human iliac artery shows potential as a vascular scaffold due to its accessibility and the ability to support the viability of hASC. Future research will emphasize in vivo validation and strategies for functional recellularization to evaluate the clinical viability of these engineered vascular grafts.