Current Outcomes and Indications for Cryopreserved Vein Allografts in Hemodialysis Access Surgery

Abstract

The rates of both primary and secondary patency in CVGs are highly comparable to the reported patency rates of polytetrafluoroethylene (PTFE) grafts and allow for lifelong maintenance of dialysis access. Our observed outcome suggests that CVGs should be considered for patients needing vascular access in the presence of infection. CVGs may likewise be viable alternatives to PTFE grafts in the elderly and patients with limited access options.

Potential Complications With Cryopreserved Cadaveric Veins in Arteriovenous Loop Formation for Head and Neck Microvascular Reconstruction

“…However, on occasion autologous donor vein options may be deficient and not readily available for use. Under these circumstances, preserved cadaveric vein may serve as an alternative vascular conduit, as reported in the literature 12–21 . Previously both cryopreserved and cold-stored cadaveric allograft options have been utilized 12,13,16,17,20 …”

“…[12][13][14][15][16][17][18][19][20][21] Previously both cryopreserved and cold-stored cadaveric allograft options have been utilized. 12,13,16,17,20 Arterialization of the venous graft occurs through cellular migration and proliferation of smooth muscles cells and myofibroblasts as well as extracellular matrix deposition. 22 These changes result in overall increase in the vascular wall thickness over a period of weeks to months.…”

“…However, there are extremely limited data overall and the reported postoperative patency among both modalities remains variable. 12,13,16,17,20 Bannazadeh et al 12 used cryopreserved allografts for infragenicular revascularization in patients with history of failed bypass or no sustainable autogenous vein in 56 patients with in-hospital graft thrombosis in 4%. In a study by Jadlowiec et al, 20 they found a 19.1% rate of thrombosis when using cryopreserved allografts for AV graft reconstruction for hemodialysis access.…”

“…Under these circumstances, preserved cadaveric vein may serve as an alternative vascular conduit, as reported in the literature. [12][13][14][15][16][17][18][19][20][21] Previously both cryopreserved and cold-stored cadaveric allograft options have been utilized. 12,13,16,17,20 Arterialization of the venous graft occurs through cellular migration and proliferation of smooth muscles cells and myofibroblasts as well as extracellular matrix deposition.…”

Cryopreserved venous allograft is an acceptable conduit in patients with current or prior angioaccess graft infection

“…6,7 Recent evidence has also suggested that cryopreserved vein allografts are better alternatives to PTFE in infected access situations and should be considered in patients with no available autogenous tissue. 8 The objectives of this study were to (1) examine the safety and efficacy of using cryopreserved vein or artery for immediate, same-site reconstruction of infected hemodialysis access conduits when no autogenous vein is available, (2) evaluate primary, primary assisted, and secondary patency rates for cryopreserved vein and artery, and (3) determine the expense of using cryopreserved vein or artery for arteriovenous access in the setting of infection by using a novel calculation unit of allograft fee per day of patency.…”