Is Fibrin a Suitable Matrix for Small-Diameter Bioartificial Vascular Grafts? An In Vitro Short-Term Hemocompatibility Study

Background: The generation of durable and hemocompatible small-diameter vascular grafts remains a major challenge in current vascular tissue engineering, as clinically available synthetic grafts are lacking hemocompatibility resulting in limited long-term patency. In recent years, fibrin has emerged as a promising scaffold material for various tissue engineering approaches due to its autologous nature, controllable fabrication, and mechanical properties. However, although pivotal for the translation into clinical application, systematic evaluation of hemocompatibility in fibrin-based small-caliber grafts is still missing. Methods: Here, the hemocompatibility of small-diameter fibrin-based grafts with and without heparin coating was compared to the current gold standard for prosthetic small-diameter vessel replacement in the form of heparin-coated ePTFE grafts using the Chandler Loop circulation model with human whole blood. Cell adhesion of thrombocytes, erythrocytes, and leucocytes was compared. Platelet activation, activation of the complement system, and plasmatic coagulation activity were assessed by ELISA analyses for P-Selectin, complement sC5b-9, and thrombin–antithrombin complex, respectively. Scanning electron microscopy (SEM) was performed to evaluate interactions and thrombocyte activation on the luminal graft surfaces. Results: The short-term hemocompatibility of the fibrin-based grafts with respect to the cell-count, activation of the coagulation pathways, and thrombocyte activation was comparable to the heparin-coated synthetic grafts even without heparin coating of the bioartificial grafts. Conclusions: The findings of this early-stage analysis support fibrin as a promising scaffold material for small-diameter vascular tissue engineering.