Controlled autologous recellularization and inhibited degeneration of decellularized vascular implants by side-specific coating with stromal cell-derived factor 1α and fibronectin

Optimized biocompatibility is crucial for the durability of cardiovascular implants. Previously, a combined coating with fibronectin and stromal cell-derived factor 1α (SDF1α) has been shown to accelerate the in vivo cellularization of synthetic vascular grafts and to reduce the calcification of biological pulmonary root grafts. In this study, we evaluate the effect of side-specific coating with SDF1α and fibronectin on the in vivo cellularization and degeneration of decellularized rat aortic implants. Aortic arch vascular donor grafts were detergent-decellularized. The luminal graft surface was coated with SDF1α, while the adventitial surface was coated with fibronectin. SDF1α-coated and uncoated grafts were infrarenally implanted (n=20) in rats and followed up for up to 8 weeks.Cellular intima population was accelerated by luminal SDF1α coating at 2 weeks (92.4 ± 2.95% vs. 61.1 ± 6.51% in controls, p<0.001). SDF1α coating inhibited neo-intimal hyperplasia, resulting in a significantly decreased intima-to-media ratio after 8 weeks (0.62 ± 0.15 vs. 1.35 ± 0.26 in controls, p<0.05). Furthermore, at 8 weeks, media calcification was significantly decreased in the SDF1α group as compared to the control group (area of calcification in proximal arch region 1,092 ± 517 µm2 vs. 11,814 ± 1,883 µm2, p<0.01). Luminal coating with SDF1α promotes early autologous intima recellularization in vivo and attenuates neo-intima hyperplasia as well as calcification of decellularized vascular grafts.