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Bacterial nanocellulose (BNC) is a promising material for small-caliber artificial blood vessels, although promoting its anticoagulant properties with more rapid endothelialization would improve long-term patency. Silk fibroin nanoparticles (SFNP) were introduced into the luminal wall surface of BNC conduits both with and without heparin (Hep) through pressurization followed by fixation. Hep was introduced in two ways: (1) embedded within SF nanoparticles to form SF-HepNPs for construction of the BNC-SF-HepNP conduit and (2) chemically grafted onto BNC and BNC-SFNP to form BNC-Hep and BNC-SFNP-Hep conduits. Fourier transform infrared spectroscopy confirmed the formation of SF-HepNPs, although they did not incorporate into the fibrillar network due to their large size. Hep was successfully grafted onto BNC and BNC-SFNP, verified by toluidine blue staining. The hemocompatibility and cytocompatibility of the five samples (BNC, BNC-SFNP, BNC-SF-HepNP, BNC-Hep, and BNC-SFNP-Hep conduits) were compared in vitro. The heparinized BNC-Hep and BNC-SFNP-Hep conduits improved the anticoagulant properties, and BNC-SFNP-Hep promoted human umbilical vein endothelial cell proliferation but also controlled excessive human arterial smooth muscle cell proliferation, assisting rapid endothelialization and improving lumen patency. No significant inflammatory reaction or material degradation was observed after subcutaneous implantation for 4 weeks. Autogenous tissues were observed around the conduits, and cells infiltrated into the edges of all samples, the BNC-SFNP conduit causing the deepest infiltration, providing an appropriate microenvironment for angiogenesis when used in small-caliber blood vessel applications. Few inflammatory cells were found around the BNC-Hep and BNC-SFNP-Hep conduits. Thus, the anticoagulant properties of the BNC-SFNP-Hep conduit and its stimulation of endothelialization suggest that it has great potential in clinical applications as a small-caliber artificial blood vessel.

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In order to improve property of bacterial nano-cellulose (BNC) to achieve the requirements of clinical application as small caliber vascular grafts, chitosan (CH) was deposited into the fibril network of the BNC tubes fabricated in unique Double-Silicone-Tube bioreactors. Heparin (Hep) was then chemically grafted into the BNC-based tubes using EDC/NHS crosslinking to improve performance of anticoagulation and endothelialization. Physicochemical and mechanical property, blood compatibility, and cytocompatibility were compared before and after compositing. The results indicated that strength at break was increased but burst pressure decreased slightly after compositing. Performance of the BNC tubes was improved remarkably after introducing chitosan and heparin. The EDC/NHS crosslinking catalyzed both amide bonds and ester bonds formation in the BNC/CH-Hep composites. Three-dimensional surface structure and roughness were firstly obtained and discussed in relation to the hemocompatibility of BNC-based tubes. This work demonstrates the heparinized BNC-based tubes have great potential in application as small-diameter vascular prosthesis.

A novel design of bioreactor G-BNC, in combination with two previously reported designs of bioreactor were used to fabricate three small caliber bacterial nanocellulose (BNC) conduits (G-BNC, S-BNC and D-BNC). They were compared systematically with a clinically-used ePTFE graft. S-BNC possessed a laminated structure, the lowest BNC content, roughest luminal surface and weakest mechanical properties, and so might not be sufficiently strong for use as an artificial blood vessel alone. The D-BNC conduit possessed an unstratified structure with a fiber network that was more dense and the greatest BNC content, providing the strongest mechanical properties. G-BNC possessed a looser network with the smoothest luminal surface and greater hemocompatibility. Following comprehensive evaluation of mechanical properties and performance, we judge that D-BNC and G-BNC should possess greater potential in application as small caliber vascular grafts, however the patency of the three BNC conduits need be further verified in animal studies in vivo.

Bacterial nano-cellulose (BNC) hydrogel has been suggested as a promising biomaterial for artificial blood vessels. However, some properties of BNC do not achieve all of the requirements of a native blood vessel - compliance, for instance. In order to improve the properties of BNC tubes, poly(vinyl alcohol) (PVA) was introduced in the BNC tubes to make composites. Two types of pristine BNC tubes with different inner structures were produced in two bioreactors. A PVA tube and PVA-BNC tubular composites were made for comparison by using a thermally-induced phase separation method. The morphology, water permeability, cytotoxicity, and mechanical properties, including the axial stretch strength, suture retention, burst pressure, and compliance of all the tubes, were evaluated and compared. The results indicated that PVA impregnated into BNC tubes and then significantly improved the properties of BNC, especially the mechanical properties and water permeability. The BNC tube itself played a great role in the performances of the composites as the skeleton base material. The PVA-BNC composite tubes could constitute new biomaterial candidates for vascular grafts.