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Original Research (Original Article) 


Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?

Johan Magnusson, Katarina Björses, Jan Holst, Martin Malina, Karolina Helczynska.

Abstract
Introduction: There is an increasing need for vascular prosthesis in dialysis medicine for the construction of arteriovenous (AV)-fistulas for dialysis access. The aims of this study were; a) to develop and validate a new experimental AV-fistula model for larger animals using grafts of bacterial cellulose (BC) between the common carotid artery and the external jugular vein; b) to observe the immediate and intermediate properties (macroscopic and angiographic patency and the macro- and micro thrombogenicity) of the grafts.
Materials and Methods: As graftmaterial bacterial cellulose was used, produced around a preformed scaffold. Bacterial cellulose (BC) is a material produced by the bacteria acetobacter xylinum. A pilotstudy was conducted on 6 pigs to validate the animalmodel and the new graftmaterial. In the following survival study a BC-graft AV-fistula was constructed in 15 pigs.
Results: In the pilot study, 5 out of 6 animals had a patent AV-fistula 4 hours after implantation. In the survival study, after 4 (n3) and 8 (n10) weeks an angiography was performed prior to explantation of the BC-graft. All grafts were occluded with a presumed platelet plug. We conducted an additional acute patch-test comparing the BC and expanded PolyTetraFluoro- Ethylene. A patch of BC and ePTFE was applied to the right and left common femoral artery respectively. At explantation three hours later, all BC-patches showed a thin gel like layer, most likely consisting of platelets, throughout the whole sur- face while the ePTFE-patch showed no, or minimal, signs of platelet adhesions.
Conclusion: Theoretically the cellulose might be similar to autologous veins considering risk of infections and thrombo- genicity. The animal model and the graft material showed good potential in the pilot study. The survival study was discour- aging with the reason for occlusion still to be explained. Bacterial cellulose has a good potential but further development and studies need to be performed.

Key words: Bacterial cellulose, animal model, AV-fistula, arteriovenous fistula, acetobacter xylinum


 
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How to Cite this Article
Pubmed Style

Magnusson J, Bjorses K, Holst J, Malina M, Helczynska K. Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?. Arch Clin Exp Surg. 2016; 5(2): 70-77. doi:10.5455/aces.20150907014645


Web Style

Magnusson J, Bjorses K, Holst J, Malina M, Helczynska K. Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?. http://www.ejmaces.com/?mno=188676 [Access: October 16, 2018]. doi:10.5455/aces.20150907014645


AMA (American Medical Association) Style

Magnusson J, Bjorses K, Holst J, Malina M, Helczynska K. Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?. Arch Clin Exp Surg. 2016; 5(2): 70-77. doi:10.5455/aces.20150907014645



Vancouver/ICMJE Style

Magnusson J, Bjorses K, Holst J, Malina M, Helczynska K. Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?. Arch Clin Exp Surg. (2016), [cited October 16, 2018]; 5(2): 70-77. doi:10.5455/aces.20150907014645



Harvard Style

Magnusson, J., Bjorses, K., Holst, J., Malina, M. & Helczynska, K. (2016) Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?. Arch Clin Exp Surg, 5 (2), 70-77. doi:10.5455/aces.20150907014645



Turabian Style

Magnusson, Johan, Katarina Bjorses, Jan Holst, Martin Malina, and Karolina Helczynska. 2016. Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?. Archives of Clinical and Experimental Surgery (ACES), 5 (2), 70-77. doi:10.5455/aces.20150907014645



Chicago Style

Magnusson, Johan, Katarina Bjorses, Jan Holst, Martin Malina, and Karolina Helczynska. "Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?." Archives of Clinical and Experimental Surgery (ACES) 5 (2016), 70-77. doi:10.5455/aces.20150907014645



MLA (The Modern Language Association) Style

Magnusson, Johan, Katarina Bjorses, Jan Holst, Martin Malina, and Karolina Helczynska. "Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?." Archives of Clinical and Experimental Surgery (ACES) 5.2 (2016), 70-77. Print. doi:10.5455/aces.20150907014645



APA (American Psychological Association) Style

Magnusson, J., Bjorses, K., Holst, J., Malina, M. & Helczynska, K. (2016) Biosynthetic bacterial cellulose graft as arteriovenous fistula – a complement to existing synthetic grafts?. Archives of Clinical and Experimental Surgery (ACES), 5 (2), 70-77. doi:10.5455/aces.20150907014645





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