Biochemical, histological, and ultrastructural assessments of pseudoneointimal linings derived from fibroblast-seeded integrally textured polymeric surfaces

Properties of blood-contacting surfaces of clinically implanted cardiac assist devices: gene expression, matrix composition, and ultrastructural characterization of cellular linings

The development of implantable cardiac assist devices for prolonged circulatory support has been impeded by the problem of excessive thrombogenesis on the blood-prosthetic interface, with subsequent embolization. To overcome this obstacle, a ventricular assist device has been developed with textured blood-contacting surfaces to encourage the formation of a tightly adherent, hemocompatible, biological lining. In this study, we applied molecular biological techniques, in conjunction with conventional ultrastructural and biochemical techniques, to characterize the biological linings associated with the blood-contacting surfaces of 11 of these devices, which had been clinically implanted for durations ranging from 21 to 324 days. No clinical thromboembolic events or pump-related thromboembolism occurred. Biological linings developed on the textured surfaces composed of patches of cellular tissue intermingled with areas of compact fibrinous material. In addition, islands of collagenous tissue containing fibroblast-like cells appeared after 30 days of implantation. Many of these cells contained microfilaments with dense bodies indicative of myofibroblasts. RNA hybridization analyses demonstrated that the colonizing cells actively expressed genes encoding proteins for cell proliferation (histones), adhesion (fibronectin), cytoskeleton (actin, vimentin) and extracellular matrix (types I and III collagen). Linings, which never exceeded 150 microns in thickness, remained free of pathological calcification. Textured blood-contacting surfaces induced the formation of a thin, tightly adherent, viable lining which exhibited excellent long-term hemocompatibility.

Molecular approaches to the characterization of cell and blood/biomaterial interactions

In order to address questions related to cell/biomaterial interactions with respect to cell function and production of extracellular matrix proteins that support or maintain cell/tissue specific properties, we have developed molecular approaches for analysis of in vivo implanted materials and in vitro studies. In an explant of a human left ventricular assist device (LVAD), intact total cellular RNA could be isolated in sufficient quantities for hybridization analyses with gene-specific probes to evaluate cell growth, cytoskeletal organization, and production of extracellular matrix proteins. Cells harvested from a 132-day implanted LVAD exhibited proliferative activity and expressed genes for fibronectin and collagen types I, III, and IV. In vitro studies revealed that endothelial cells cultured on two different segmented polyurethane biomaterials (Biomer and Tecoflex 60D) exhibited different patterns of gene expression that reflected differences in cell growth rates, morphology, and composition of the extracellular matrix. These methodologies provide a valuable approach for a detailed evaluation of: (1) the biocompatibility of cells colonizing implanted cardiac assist devices; and (2) the functionality of cells seeded onto biomaterials.

Biochemical characterization of connective tissue reaction to synthetic polymer implants

The present review is concerned with the significance and prospects of the use of biochemical methods to characterize connective tissue reaction to implanted synthetic polymer materials. The necessity of carrying out complex quantitative analysis of capsules developing around the implants in order to elucidate qualitative peculiarities of the reaction and to objectify the assessment of the reactogeneity of the material is emphasized.

Endothelial cell labeling with indium-111-oxine as a marker of cell attachment to bioprosthetic surfaces

Canine vascular endothelium labeled with indium-111-oxine was used as a marker of cell attachment to vascular prosthetic surfaces with complex textures. Primarily cultured and freshly harvested endothelial cells both took up the label rapidly. An average of 72% of a 32 micro Ci labeling dose was taken up by 1.5 X 10(6) cells in 10 min in serum-free medium. Over 95% of freshly labeled cells were viable by trypan blue tests and only 5% of the label was released after 1 h incubations at 37 degrees C. Labeled and unlabeled cells had similar rates of attachment to plastic dishes. Scanning electron microscopic studies showed that labeled cells retained their ability to spread on tissue culture dishes even at low (1%) serum levels. Labeled endothelial cells seeded onto Dacron or expanded polytetrafluoroethylene vascular prostheses by methods used in current surgical models could be identified by autoradiography of microscopic sections of the prostheses, and the efficiency of cell attachment to the prosthesis could be measured by gamma counting. Indium-111 labeling affords a simple and rapid way to measure initial cell attachment to, and distribution on, vascular prosthetic materials. The method could also allow measurement of early cell loss from a flow surface in vivo by using external gamma imaging.