Abstract Introduction Small-diameter vascular grafts are crucial for patients undergoing coronary artery bypass surgery. Inherent comorbidities and the absence of optimal autologous vessels have prompted the development of vascular grafts through tissue engineering. The objective of the study is to develop a human biological substitute, VasCraft, for use as a coronary bypass graft. Methods VasCraft is an inter-institutional project carried out in four phases (F1–F4) for the design, development, and production of the bioimplant.F1: Decellularization of human cadaveric saphenous veins. The optimal decellularization protocol was identified by evaluating extracellular matrix (ECM) preservation, residual DNA content, morphohistological structure, and cytotoxicity.F2: Reendothelialization using endothelial cells derived from Wharton’s jelly mesenchymal stem cells (EC-MSC, WJ) in 3D bioreactors.F3: Generation of an Advanced Therapy Medicinal Product (ATMP) under Good Manufacturing Practice (GMP) conditions.F4: Pre-clinical validation of the VasCraft ATMP in the femoro-femoral position in a porcine model. Graft implantation was monitored fluoroscopically, and structural and inflammatory assessments were performed at 30 days post-implantation. Results Eleven decellularization protocols were tested. All protocols achieved a DNA concentration of less than 50 ng/mg of dry tissue. Protocol 1 was selected due to its high preservation of the morphology and ECM of the decellularized vein and the low cytotoxicity of the decellularization reagents. Additionally, a 3D bioreactor was developed to facilitate the recellularization of grafts with EC-MSC, WJ under continuous flow conditions. Conclusion The VasCraft bioimplant aims to solve an unmet need in the development of artificial vascular grafts. Phases F1 and F2 are well underway, with plans to move into Phases F3 and F4 in the coming months.
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