The Peritoneum as a Natural Scaffold for Vascular Regeneration

Abstract

Objective The peritoneum has the same developmental origin as blood vessels, is highly reactive and poorly thrombogenic. We hypothesize that parietal peritoneum can sustain development and regeneration of new vessels. Methods and Results The study comprised two experimental approaches. First, to test surgical feasibility and efficacy of the peritoneal vascular autograft, we set up an autologous transplantation procedure in pigs, where a tubularized parietal peritoneal graft was covered with a metal mesh and anastomosed end-to-end in the infrarenal aorta. Second, to dissect the contribution of graft vs host cells to the newly developed vessel wall, we performed human-to-rat peritoneal patch grafting in the abdominal aorta and examined the origin of endothelial and smooth muscle cells. In pig experiments, the graft remodeled to an apparently normal blood vessel, without thrombosis. Histology confirmed arterialization of the graft with complete endothelial coverage and neointimal hyperplasia in the absence of erosion, inflammation or thrombosis. In rats, immunostaining for human mitochondri revealed that endothelial cells and smooth muscle cells rarely were of human origin. Remodeling of the graft was mainly attributable to local cells with no clear evidence of c-kit+ endothelial progenitor cells or c-kit+ resident perivascular progenitor cells. Conclusions The parietal peritoneum can be feasibly used as a scaffold to sustain the regeneration of blood vessels, which appears to occur through the contribution of host-derived resident mature cells.

Enhanced Vascular Biocompatibility and Remodeling of Decellularized and Secured Xenogeneic/Allogeneic Matrices in a Porcine Model

“…Moreover, in contrast to Bonvini et al[21] who showed the need of an external tutor to a tubularized autologous nondecellularized PPt to promote acquisition of an arterial phenotype, the tubularized DPPt in our study showed acquisition of an arterial phenotype and no aneurysm appearance without the need of tutor. This observation suggests the superiority of our DPPt to autologous PPt for cardiovascular reconstruction in the pig.…”

Modulating electrospun polycaprolactone scaffold morphology and composition to alter endothelial cell proliferation and angiogenic gene response

“…These include mechanical cues, biochemical cues (incorporation of native ECM (extracellular matrix), protein binding, etc.) and bioelectric cues (electrical stimulation) [2][3][4][5][6][7][8][9][10][11]. Electrospinning is an exciting avenue that allows for a wide range of scaffold morphologies to be created [12][13][14][15].…”

Inferior vena cava reconstruction with non‐fascial autologous peritoneum: Retrospective study and literature review

“…38 Bonvini et al Observed that the parietal peritoneum acts as a scaffold to support blood vessel regeneration. 39 In other experimental animal studies, complete endothelialization of peritoneal grafts was observed as early as 2 weeks after implantation. 40,41 Chin et al first described the use of FAP for partial IVC reconstruction in 6 patients in 1999 and later in 22 complete IVC reconstructions, with no reported complications.…”