Decellularized vascular grafts

Cardiovascular disease is one of the main causes of mortality and morbidity worldwide. The “gold standard” for the replacement/repair of diseased blood vessels is substitution with autologous vessels. However, multiple surgical procedures limit the availability of autologous vessels, whereas synthetic grafts have been reported to demonstrate poor patency rates, especially for small-caliber vascular reconstructions. Decellularization of native vascular or non-vascular tissues for vascular scaffold development has gained significant attention in the past 20 years. A variety of decellularization techniques have been described and employed to achieve effective immunogenic agent removal from the developed vascular scaffold. At the same time, the decellularization must not impair the extracellular matrix (ECM) composition, structure, and mechanical properties of the graft in order to ensure long-term functionality in vivo. The aim of this chapter was to review the various decellularization treatments that have been reported in the literature for the development of decellularized vascular scaffolds.