There have been numerous attempts to develop prosthetic conduits or utilize allograft saphenous veins for arterial bypass. This article summarizes our experimental and clinical experience with cryopreserved allograft saphenous veins. During these studies, particular attention was paid to vein donor postmortem ischemia time, vein procurement technique, and tissue storage methods. Experimental cryopreserved autograft studies demonstrated that cryopreservation of the veins does not alter subsequent graft patency, the arterialization process, blood flow, or platelet deposition in vein grafts. Endothelium-derived relaxing and contractile factors are produced by the endothelium of explanted cryopreserved autografts, and smooth muscle contractions and relaxations can be induced. In experimental cryopreserved allografts, the endothelium appears to be removed by an immune response during the first 10 days after transplantation, fibrin deposition is minimal, and re-endothelialization occurs over 6-9 months. Early clinical results using cryopreserved allograft saphenous veins are encouraging with 1-year patency rates of 79% for peripheral grafts and 86% for coronary bypass grafts.

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Allograft heart valves have been used for over 30 years. During the first decades of use, the research and clinical objectives were to find a means for long-term storage of tissue. Methods such as irradiation, glutaraldehyde fixation, long-term antibiotic storage at 4 degrees C and other methods were common. These methods, however, were found to give reduced long-term clinical performance when compared with viable fresh tissue or tissue which had been cryopreserved. Recognizing this fact, more recent emphasis has been to address issues surrounding means by which allografts can be cryopreserved and thawed to retain maximum viability. An additional concern was to find a means to maximize donor retrieval by salvaging tissue which normally would be discarded because of bacterial contamination. This study demonstrates that when a proper cryopreservation technique is used, with stringent antibiotic treatments, biomechanical parameters remain normal with only a slight decrease in cell viability.

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