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Blood, Vol. 95 No. 2 (January 15), 2000:
pp. 581-585
Enhanced endothelialization and microvessel formation in
polyester grafts seeded with CD34+ bone marrow cells
Vishwanath Bhattacharya,
Peter A. McSweeney,
Qun Shi,
Benedetto Bruno,
Atsushi Ishida,
Richard Nash,
Rainer F. Storb,
Lester R. Sauvage,
William P. Hammond, and
Moses Hong-De Wu
From The Hope Heart Institute and Providence Seattle Medical Center,
the Fred Hutchinson Cancer Research Center, and the Departments of
Surgery and Medicine, University of Washington School of Medicine,
Seattle, WA.
The authors have shown accelerated endothelialization
on polyethylene terephthalate (PET) grafts preclotted with autologous bone marrow. Bone marrow cells have a subset of early progenitor cells
that express the CD34 antigen on their surfaces. A recent in vitro
study has shown that CD34+ cells can differentiate into
endothelial cells. The current study was designed to determine whether
CD34+ progenitor cells would enhance vascular graft
healing in a canine model. The authors used composite grafts implanted
in the dog's descending thoracic aorta (DTA) for 4 weeks. The 8-mm × 12-cm composite grafts had a 4-cm PET graft in the center and 4-cm
standard ePTFE grafts at each end. The entire composite was coated with silicone rubber to make it impervious; thus, the PET segment was shielded from perigraft and pannus ingrowth. There were 5 study grafts
and 5 control grafts. On the day before surgery, 120 mL bone marrow was
aspirated, and CD34+ cells were enriched using an
immunomagnetic bead technique, yielding an average of 11.4 ±
5.3 × 106. During surgery, these cells were mixed with
venous blood and seeded onto the PET segment of composite study grafts;
the control grafts were treated with venous blood only.
Hematoxylin and eosin, immunocytochemical, and AgNO3
staining demonstrated significant increases of surface
endothelialization on the seeded grafts (92% ± 3.4% vs 26.6% ± 7.6%; P = .0001) with markedly increased microvessels in
the neointima, graft wall, and external area compared with controls. In
dogs, CD34+ cell seeding enhances vascular graft
endothelialization; this suggests practical therapeutic applications.
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