Synthetic vascular graft that heals and regenerates

Abstract

Millions of synthetic vascular grafts (sVG) are needed annually to address vascular diseases (a leading cause of death in humans) and kidney failure (as vascular access). However, in 70+ years since the first sVG in humans, we still do not have sVGs that fully endothelialize (the "holy grail" for truly successful grafts). The lack of healthy endothelium is believed to be a main cause for thrombosis, stenosis, and infection (the major reasons for graft failure). The immune-mediated foreign body response to traditional sVG materials encapsulates the materials in fibrotic scar suppressing vascularized healing. Here, we describe the first sVG optimized for vessel wall vascularization via uniform, spherical 40 μm pores. This sVG induced unprecedented rapid healing of luminal endothelium in a demanding and clinically relevant sheep model, probably by attracting and modulating macrophages and foreign body giant cells towards diverse, pro-healing phenotypes. Both this sVG and the control (PTFE grafts) remained 100 % patent during the implantation period. This advancement has broad implications beyond sVGs in tissue engineering and biocompatibility.