Origin of endothelial cells that line expanded polytetrafluoroethylene vascular grafts sodded with cells from microvascularized fat

Abstract

Cell transplantation onto prosthetic vascular grafts remains an attractive technique to reduce the thrombogenicity of polymeric materials. In this study we evaluated whether autologous cells isolated from falciform ligament fat and transplanted onto the lumenal surface of 4 mm expanded polytetrafluorethylene grafts were the same cells present on the surface of these grafts when they were explanted from canine carotid arteries 3 weeks after their implantation. The fluorescent dye PKH-26 was used to label transplanted cells to evaluate their fate after implantation of grafts as carotid artery replacements. This fluorescent dye homogeneously labeled all cells in the primary cell isolate. In vitro studies indicated that dye labeling was nontoxic, as evidenced by the normal growth characteristics of fluorescently labeled cells compared with nonlabeled cells. Immunocytochemical analysis of microvascularized fat before cell isolation determined that approximately 90% of the cells stained positive for von Willebrand factor2. At the time of explant, seeded grafts exhibited a nonthrombogenic lumenal cell lining as evidenced by the lack of adherent platelets or fibrin. Cells on the lumenal surface of grafts exhibited PKH-26 fluorescence emission. In addition, these cells expressed von Willebrand factor and actively sequestered DiI-acetylated low-density lipoprotein. We conclude that sodding of prosthetic grafts with autologous microvascularized fat-derived cells results in the formation of an endothelial cell lining on the lumenal flow surface. These endothelial cells are the same cells placed on the lumenal surface of the graft at the time of initial cell transplantation. Finally, a confluent monolayer forms after high-density cell sodding by the process of cell adherence and spreading, without the need for cell proliferation.