THE ISOLATION OF A FIBROBLAST GROWTH INHIBITOR ASSOCIATED WITH PERIGRAFT SEROMA

Purpose: Perigraft seroma is a rare complication of reconstructive vascular surgery characterized by a clear, sterile fluid collection confined within a fibrous pseudomembrane around a prosthetic graft. The exact cause of this disease is unknown but involves failure of surrounding connective tissue to incorporate the graft. To understand why this occurs, we studied sera from patients with perigraft seroma for their effect on human fibroblasts. Sera from control subjects, patients with uninfected prosthetic grafts, and patients with prosthetic grafts were tested for comparison. Methods: Fibroblast growth was measured by radioactive thymidine uptake and hexosaminidase colorimetric cell proliferation assays. We fractionated sera with gel filtration columns and measured each fraction's effect on fibroblast growth. Results: Serum samples from patients with perigraft seroma inhibited fibroblast growth in a dose-dependent manner. In contrast, a postseroma sample, normal human sera, and sera from patients with infected and uninfected grafts showed no significant fibroblast inhibition. An inhibitory factor with a molecular weight of 2000 d was isolated from serum of patients with perigraft seroma. Conclusions: Perigraft seroma is associated with a fibroblast inhibitor with a molecular weight of 2000 d. Further identification and characterization of this protein may lead to clinical applications in preventing and treating perigraft seroma.