Cryopreserved Vein Transplantation

Abstract

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.

The minimal dose of FK506 is sufficient to facilitate the arterialisation of venous allografts in rats

“…To lower the high rate of thrombosis, which is enhanced by rejection, immunosuppressive treatment has been administered to patients with venous allografts in some centres [2,3]. Cyclosporine A, a calcineurin inhibitor, is most frequently used for immunosuppression [2,4,5]. In our previous experimental work, we confirmed that immunosuppressive therapy is required for venous allograft adaptation to arterialisation in rats.…”

Fifteen years of infrapopliteal arterial reconstructions with cryopreserved venous allografts for limb salvage

“…[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] Comparison was made difficult because these grafts were used for different indications (some for replacement of infected grafts) and because different methods of harvesting, preservation, and immunosuppressive therapy were used. Through careful graft selection, meticulous immunosuppressive therapy with cyclosporine, and careful follow-up, we could obtain 1-year secondary patency comparable with the best published results.…”

Homograft saphenous vein versus polytetrafluoroethylene graft for modified Blalock -Taussig shunt

“…Cryopreservation of homografts 9,15 has been shown to be superior preservation technique as the donor cellular elements remain viable and prolong longevity of homograft. However previous experiment by Bogats et al 5 At our center we harvest and preserve the veins ourselves without involving any commercial firms and this helps us to cut down the costs of this procedure significantly.…”

“…Homograft Vein preservation and Banking [9][10][11] Extra segments of saphenous veins remaining at the end of coronary artery bypass grafting and those obtained from live brain-dead donors who are candidates for organ donation are used. Although we have the facility for cryopreservation of heart valves, we use antibiotic-preservation for homograft veins.…”