Abstract 15460: Successful Implantation of an Allogenic In-Body Tissue-Engineered Vascular Graft (Biotube) for Hemodialysis Access in a Beagle Model
Background and Objective: In patients receiving hemodialysis, vascular access via an autologous arteriovenous (AV) shunt is preferred because of its lower rates of all-cause mortality and infection. However, a substantial number of shunt will fail because of stenosis or obstruction at anastomotic site or venous outflow. On the other hand, we developed in-body tissue-engineered vascular grafts (Biotubes), exhibited rapid tissue regeneration and withstand systemic pressure over 5 years. In this study, allogeneic Biotubes were stored for over 1 month and firstly implanted as canine AV hemodialysis shunts.
Methods and Results: Biotube vascular grafts (n=9) with 4 mm in diameter and 5 cm in length were prepared as connective tubular tissues with wall thickness of ca. 1 mm by embedding of the molds, assembled with a silicone center rod and a stainless steel tube, into canine abdominal subcutaneous pouches for 2 months. After anti-thrombogenic coating, they were allogeneic implanted between the carotid artery and jugular vein of beagles as an AV shunt in three methods; side-to-side anastomosis at aorta side and end-to-end at vein side (Method 1, n=4), side-to-side anastomosis at both sides (Method 2, n=4), and end-to-side at both sides (Method 3, n=1). Interestingly, two Biotubes could be connected to obtain long length (10 cm). Following placement of Biotubes, continuous thrill was felt by palpation and ultrasound showed turbulent blood flow. After one month, all Biotubes were patent and angiography showed no stenosis, elongation, or hemorrhage. Percutaneous puncturing with a needle, blood removal and resupply from the needle, and astirction within several minutes were feasible.
Conclusion: In a beagle model, allogeneic Biotubes successfully created an AV shunt that maintained steady blood flow in three methods, suggesting that Biotubes is available off-the-shelf with high potential clinical use in maintaining vascular access for hemodialysis.
Author Disclosures: Y. Nakayama: None. M. Furukoshi: None.
- © 2016 by American Heart Association, Inc.