R. I. Vazquez-Padron1, J. C. Duque1, M. Tabbara1, L. H. Salman1, R. I. Vazquez-Padron1 1University Of Miami,Vascular Surgery,Miami, FL, USA
Introduction:
The role of immune cells in arteriovenous (A-V) fistulae maturation is poorly understood and has received, until quite recently, little attention. This study examines the role of T-lymphocytes in A-V fistula vascular remodeling and maturation.
Methods:
Experimental A-V fistulae were created in two groups of athymic nude rats lacking mature T-lymphocytes, and euthymic control animals by anastomosing the left superior epigastric vein to the nearby femoral artery. Histopathogical analysis and morphometric assessment of venous wall thickness and real luminal area was performed at 30 days post surgery. Flow measurements were recorded using a Transonic Flowmeter system.
Results:
The absence of T-lymphocytes compromised blood flow and increased failure rate. Immunodeficiency caused a constrictive vascular remodeling characterized by a reduced lumen, a thick muscular layer and a low number of inflammatory cells. The adoptive transfer of CD4+ T-lymphocytes from euthymic rats prior and after fistula creation in athymic animals prevented negative remodeling
Conclusion:
These results point at the key role of CD4+ T-lymphocytes in the proper remodeling of the A-V fistula vascular wall