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Complement activation by synthetic vascular prostheses.

A D Shepard, J A Gelfand, A D Callow

    Journal of Vascular Surgery
    |November 1, 1984
    PubMed
    Summary
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    Synthetic grafts trigger significant complement activation, particularly Dacron, potentially hindering endothelial cell seeding. Polytetrafluoroethylene (PTFE) showed minimal complement activation, suggesting better biocompatibility for vascular prostheses.

    Area of Science:

    • Biomaterials Science
    • Immunology
    • Vascular Surgery

    Background:

    • Polymorphonuclear leukocytes (PMNs) infiltrate synthetic grafts, and complement-activated PMNs can damage endothelial cells.
    • Complement activation by graft materials may impede successful endothelial cell seeding on prosthetic grafts.

    Purpose of the Study:

    • To investigate whether synthetic vascular prostheses activate the complement system.
    • To determine if graft material type influences the extent of complement activation.

    Main Methods:

    • Assayed plasma from 10 healthy donors for complement activity after incubation with Dacron and PTFE graft segments.
    • Measured C5a generation using radioimmunoassay and granulocyte aggregometry.
    • Assessed functional complement pathway activity (classical and alternative) via hemolytic assays.

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    Main Results:

    • Knitted Dacron grafts demonstrated substantial complement activation.
    • Polytetrafluoroethylene (PTFE) grafts exhibited negligible complement activation.
    • Dacron-induced complement activation involved both classical and alternative pathways.

    Conclusions:

    • Dacron grafts activate the complement system significantly, potentially impacting their performance in small-caliber vascular applications.
    • PTFE grafts show a lower propensity for complement activation, indicating potential advantages for vascular prostheses.
    • Complement reactivity of biomaterials is a critical factor for the success of synthetic vascular grafts.