Tissue Engineering of Vascular Grafts

Tissue engineering of vascular grafts addresses the pressing need for small-diameter conduits in revascularisation and bypass procedures, overcoming the limitations of autologous harvest and synthetic prostheses. The field combines biomaterial scaffolds, cell biology and biomechanical conditioning to recreate vessels that match the native architecture and function of arteries. Scaffold types range from natural polymers and decellularised matrices to synthetic and hybrid composites. Fabrication methods such as electrospinning, three-dimensional printing and bioprinting provide precise control over microstructure, porosity and mechanical compliance. Strategies include in vitro cell seeding with endothelial and smooth muscle cells under dynamic flow, and in situ approaches that harness host cell recruitment and remodelling. Key design criteria encompass long-term patency, rapid endothelialisation, suppression of thrombosis and intimal hyperplasia, mechanical strength and compliance matching. Recent advances have moved beyond simple cell-laden constructs to acellular grafts with instructive cues for host-mediated regeneration, and multifunctional coatings that promote healing without drug elution. Clinical translation remains challenged by scaling production, immune compatibility and validation of long-term performance, yet emerging biomaterials and manufacturing techniques continue to bring patient-specific, off-the-shelf grafts within reach.

Research from Nature Portfolio

Recent studies have demonstrated that a drug-free stent coating functionalised with recombinant human type III collagen can orchestrate anticoagulation, anti-inflammatory effects and suppression of neointimal hyperplasia. This one-produces-multi system accelerates endothelialisation, promotes a contractile smooth muscle phenotype and reduces restenosis in preclinical models.

Proof-of-concept work on acellular grafts grown from donor fibroblasts in fibrin gel has shown somatic growth potential in young lambs. Decellularised constructs implanted as pulmonary artery replacements grow synchronously with the host, develop organised smooth muscle and endothelial layers, deposit elastin and collagen, and maintain mechanical strength without stenosis or calcification.

Tissue Engineering of Vascular Grafts publication trend

The graph below shows the total number of articles in tissue engineering of vascular grafts across all publications each year (not limited to Nature Index journals).

Technical terms

Tissue-engineered vascular graft (TEVG): A bioengineered conduit combining cells, biomaterials and biophysical stimuli to replace or repair damaged blood vessels.

Endothelialisation: The process by which endothelial cells line the inner surface of a graft, forming a non-thrombogenic layer.

Smooth muscle layer (SML): The medial vessel layer composed of contractile smooth muscle cells that confer compliance and contractility to the vessel wall.

Hemocompatibility: The property of a material to interact with blood without causing adverse reactions such as thrombosis or haemolysis.

Decellularisation: Removal of cellular components from a tissue matrix, leaving an extracellular scaffold to minimise immune rejection and support host cell repopulation.

Electrospinning: A fabrication technique using an electric field to draw fine polymer fibres into a porous scaffold that mimics the extracellular matrix.

References

1. 3D printed grafts with gradient structures for organized vascular regeneration. International Journal of Extreme Manufacturing (2024).
2. A drug-free cardiovascular stent functionalized with tailored collagen supports in-situ healing of vascular tissues. Nature Communications (2024).
3. Tissue engineering of acellular vascular grafts capable of somatic growth in young lambs. Nature Communications (2016).
4. Tissue-Engineered Small Diameter Arterial Vascular Grafts from Cell-Free Nanofiber PCL/Chitosan Scaffolds in a Sheep Model. PLOS ONE (2016).
5. Challenges and strategies for in situ endothelialization and long-term lumen patency of vascular grafts. Bioactive Materials (2020).