Evaluation of in situ tissue-engineered arteriovenous grafts suitable for cannulation in a large animal model

Abstract The sustainability of vascular access for hemodialysis is limited by frequent interventions and the inability of synthetic grafts to self-heal. Tissue engineering offers a solution through biodegradable grafts that remodel into autologous tissue. Here we assess electrospun polycarbonate-bis...

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Main Authors: Paul J. Besseling, Wojciech Szymczyk, Martin Teraa, Raechel J. Toorop, Paul. A. A. Bartels, Boris Arts, Rob C. H. Driessen, Arturo M. Lichauco, Hidde C. Bakker, Joost O. Fledderus, Gert J. de Borst, Patricia Y. W. Dankers, Carlijn V. C. Bouten, Marianne C. Verhaar
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Communications Materials
Online Access:https://doi.org/10.1038/s43246-025-00879-z
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Summary:Abstract The sustainability of vascular access for hemodialysis is limited by frequent interventions and the inability of synthetic grafts to self-heal. Tissue engineering offers a solution through biodegradable grafts that remodel into autologous tissue. Here we assess electrospun polycarbonate-bis urea (PC-BU) vascular scaffolds (6mm-inner-Ø), reinforced with 3D-printed polycaprolactone coils, in a goat model, and compared them to expanded polytetrafluoroethylene (ePTFE) controls. The tissue-engineered grafts were repeatedly cannulated starting two weeks after implantation and were evaluated using computed tomography and histological analyses. By 12 weeks, the PC-BU grafts remodel into autologous tissue while maintaining structural integrity, maintaining integrity without dilations, ruptures, or aneurysms. Cannulation does not interfere with scaffold degradation or neo-tissue formation. Although the patency rate is lower for the PC-BU grafts (50%) compared to ePTFE (100%), the engineered grafts exhibit a self-healing response not seen in ePTFE. These findings demonstrate the potential of PC-BU tissue-engineered grafts as healing, functional vascular access solutions for hemodialysis, supporting cannulation during tissue transformation.
ISSN:2662-4443