IN-VITRO ENDOTHELIALIZATION OF ARTERIOVENOUS LOOP GRAFTS FOR HEMODIALYSIS

Objectives: To evaluate feasbility in a pilot study of in vitro endoth elialsation of PTFE grafts used as interposition arteriovenous fistula s in uraemic patients. Methods: Autologous saphenous vein endothelial cells were harvested and cultured on PTFE grafts in seven patients und ergoing maintenance haemodialysis. The patients had several previous f ailures of vascular access sites. The patients were followed with dupl ex ultrasound, clinical examination and in one case an explanted graft was examined. Results: At the end of follow-up four of the seven pati ents had patent grafts. One patient occluded the graft immediately pos toperatively and another after 3.5 months. The former patient received a second endothelialised graft. In two further patients revision of t he outflow was performed. In two patients a functioning ring graft was excised, in one case because of bleeding of a venous aneurysm and in one case because of suspected infection. The former which was excised 5 weeks postoperatively revealed that 85% of the surface tons covered by endothelial cells. Conclusions: This pilot study shows that in vitr o endothelialisation of PTFE grafts used for haemodialysis is possible in uraemic patients. In this highly problematic patient group the res ults are promising with endothelial cell coverage after 5 weeks of imp lantation.