Arthur C. Hill, M.D., Associate Professor of Clinical Surgery
 
Current research interests focus on pre-clinical and clinical development of new medical technology. Current research efforts has included 1.) vascular peptide coating to promote endothelial adhesion and proliferation; 2.) medical uses of Nitinol; 3.) anastomotic technology for use in minimally invasive and robotic CABG; 4.) Nitinol for aortic, mitral and tricuspid repair and replacement; 5.) PLAATO Left Atrial Appendage Occlusion Device for Treatment of Atrial Fibrillation; and 6.) Sealant, Super-sealant, and hemostatic devices used in Surgery.

ePTFE arterial-venous shunts are commonly associated with neo-intimal ingrowth which can lead to graft thombosis and occlusion. I am co-Principal Investigator in a study designed to compare the efficacy of P15 cell-binding peptide coated ePTFE A-V grafts to 1.) decrease neo-intimal tissue in-growth at the arterial and venous ends of A-V shunts, 2.) improve the uniformity and smoothness of endothelial cell resurfacing of the graft and, 3.) improve patency of the A-V graft in sheep compared to untreated ePTFE A-V grafts. P-15 is a synthetic peptide which contains the 15 amino acid sequence GTPGPQGIAGQRGVV. P-15 has been identified as the cell adhesion domain within Type I Collagen. P-15 peptide coated materials have been shown in in vitro studies to enhance cell adhesion and proliferation.

The study demonstrated that P-15 coated ePTFE grafts had less intimal tissue in-growth at the venous anastomosis compared to uncoated ePTFE grafts. The degree of smooth and laminar endothelial cell resurfacing of coated grafts was greater in coated compared to uncoated grafts. This is consistent with previous in vitro studies using human umbilical vein endothelial cells (HUVEC). In these studies, P-15 coated ePTFE graft materials had significantly improved cell adhesion, proliferation, and migration compared to uncoated ePTFE. It appears that P-15 coated ePTFE produces a strong mechanical and biological interaction between the graft surface and the newly formed endothelial lining, and can potentially improve the long term patency of the graft.