Enhanced patency of venous Dacron grafts by endothelial cell sodding.

The effect of microvessel endothelial cell (EC) sodding on the patency of Dacron grafts interposed in canine inferior vena cava was studied. EC were harvested enzymatically from canine omentum and isolated by density gradient centrifugation. Preclotted, knitted Dacron grafts were sodded with > 10(6) EC/cm2 surface. The results demonstrate significant improvement in patency of sodded grafts placed in the inferior vena cava as compared with control grafts (p < 0.001 in grafts with a distal arteriovenous fistula and p < 0.05 in grafts without a distal fistula). The neointima of the sodded grafts were thinner and scanning electron microscopy confirmed the presence of a confluent layer of EC. In addition, the production of prostacyclin but not thromboxane A2 was significantly enhanced in the sodded grafts as compared with controls. We conclude that microvessel EC sodding of Dacron grafts significantly improves the patency rate and inhibits neointimal thickening of the prosthesis. The mechanism is unknown but may involve a more rapid endothelialization of the graft surface with the potential of producing more prostacyclin and less thromboxane A2.