Scalable microvascular networks-on-chip enable 8-week unidirectional perfusion for long-term vascular toxicity screening

Cardiovascular toxicity is a leading cause of late-stage drug attrition, yet current in vitro vascular models lack the longevity and scalability needed to capture clinically relevant responses in mature vasculature. We developed a vascular microphysiological system comprising 32 parallel, self-assembled microvascular networks from primary human endothelial cells and stromal fibroblasts. Networks were unidirectionally perfused by gravity-driven, pump-free flow. They remained functionally perfusable for at least 57 days, the longest duration reported for self-assembled microvascular networks, and underwent progressive maturation characterised by perivascular fibroblast organisation, basement membrane deposition, and matrix remodelling. Variance decomposition confirmed high reproducibility, with intra-plate variability of 3–7% and no operator-dependent effects on network morphometry. Exploiting this extended culture window, we reveal maturation-dependent shifts in endothelial inflammatory responsiveness and cytotoxic susceptibility. Distinct acute and chronic toxicity profiles of clinically used tyrosine kinase inhibitors are resolved, and a concentration- and time-dependent spectrum of sorafenib-induced microvascular responses is produced. These results show that vascular longevity and progressive maturation are key requirements for assessing vascular toxicity, and provide a scalable platform for evaluating acute and chronic drug responses in mature human microvascular tissues.