A Review on the Clinical Application for Tissue Engineered Vascular Grafts

Cardiovascular-related medical conditions remain a significant cause of death worldwide despite the advent of tissue engineering research more than half a century ago. There is a continued and growing demand for vascular conduits for reconstructing or bypassing vascular occlusion and aneurysms. Although autologous tissue is still the preferred treatment, donor tissue is limited, and there remains a need for tissue engineered vascular grafts (TEVGs). The production of particularly large vascular tissue (> 1 cm3) in vitro meets the clinical needs of tissue grafts and biological research applications. The use of TEVGs in human patients remains limited due to issues related to thrombogenesis and stenosis. In addition to the advancement of simple manufacturing methods, the shift of attention to the combination of synthetic polymers and bio-derived materials and cell sources has enabled synergistic combinations of vascular tissue development. The aim of the study was to propose potential solutions and prospects in this highly dynamic field of research. This review detailed the selection of biomaterials and cell sources and related clinical trials in developing large diameter vascular grafts that can be applied clinically. Finally, the remaining challenges in the tissue engineering field which can be seen from complex requirements by covering both basic and clinical research from the perspective of material design, have been discussed. The study concludes that while autologous tissue has been successfully used to treat many cardiovascular diseases (e.g., atherosclerosis), autologous vascular tissue for transplantation is often insufficient. Therefore, the development of TEVGs offers a promising alternative. Advances in TEVG manufacturing technologies could potentially address these limitations in the near future. Additionally, the ability to 3D print vascular grafts with satisfactory properties is now a reality, offering new possibilities for treatment.