Chronic kidney disease and stromal cell-derived factor 1α peptide-functionalization impact on polycarbonate-bisurea based in situ tissue-engineered vascular graft dynamics.

Bioresorbable grafts offer promise for in situ tissue engineered blood vessels (TEBVs), yet balancing graft degradation and neo-tissue formation remains challenging. Chronic kidney disease (CKD) may affect this balance, potentially limiting TEBV effectiveness in CKD-patients. To investigate this, we implanted electrospun, polycarbonate-bisurea (PC-BU) TEBVs in healthy (sham) and 5/6th-nephrectomy-induced CKD rats. Additionally, we evaluated whether stromal cell-derived factor 1α (SDF-1α)-peptide functionalization improved outcomes. TEBVs were explanted after two weeks (sham or CKD) or three months (sham). After two weeks, patency was 100% in sham (n = 13) and CKD (n = 12) explants, all containing an endothelial lining (RECA), smooth muscle (αSMA) and inflammatory (CD68) cells. Graft degradation was evident in all groups with similar uniaxial tensile strength independent of group or timepoint. Lumen dilatation was observed in three-month sham explants (n = 8), accompanied by limited inflammation. From three weeks post-implantation onwards, graft degradation-related TEBV rupture and fatality occurred in n = 4 sham. The CKD arm was discontinued due to rapid disease progression. Independent of disease or timepoint, SDF-1α-peptide-functionalization did not impact patency, tissue formation or graft degradation. In conclusion, PC-BU TEBVs supported rapid neo-tissue formation and maturation but were prone to unpredicted failure. Neither CKD nor SDF-1α functionalization influenced patency, neo-tissue formation or graft degradation.