Historical Overview of Vascular Allograft Transplantation

Abstract

There is a mix of therapeutic options for revascularisation in vascular surgery. The authors performed a literature review on the evolution of vascular allograft transplantation and its use and acceptance by vascular surgeons. This review exposed three stages: the first stage involved preliminary experimentation; the second stage was a decline in use due to long-term complications, and the third stage is its current use in special indications subject to a thorough analysis. There are few indications for the use of vascular allografts in clinical guidelines. However, there are publications of long series of case studies with variable results reflecting international use of the procedure.There is a current trend that favours its use with limited and individualised indications.

The mechanical characterization of blood vessels and their substitutes in the continuous quest for physiological-relevant performances. A critical review

“…The first publication on vascular replacement surgery was in 1906, in which a segment of vein from the own patient was used to replace a diseased vessel [ 5 ]. Their unsatisfactory long-term results led to the investigation of techniques for collection, processing, and storage of grafts and to the exploration of synthetic prostheses [ 6 ]. Currently, polyethylene terephthalate (PET, Dacron®) and expanded polytetrafluoroethylene (PTFE, Teflon®) conduits have been applied for high flow state in large-diameter vessels (>6 mm).…”

Resultados de los transplantes de aloinjertos vasculares en la comunidad autonoma de Cataluña, España

“…Consequently, only a clear indication is covered by guidelines, the replacement of infected grafts in aortic position because after several series and publications, they have shown a lower reinfection rate and to be a reliable alternative. However, the first aspect to consider is that most of the unfortunate results of allografts were observed in other territories and indications 1 .…”

“…Thanks to the improving of cryopreservation techniques and arising of new concepts of immunobiology, some less popular practices such as tissue transplantation have evolved to become a common practice. In fact, transplantation of cryopreserved arterial allografts is accepted as a suitable alternative by American and European guidelines of Vascular Surgery [1][2][3] .…”

“…At present, vascular allografts have been reconsidered for specific indications. This reconsideration of allografts, undoubtedly, was due to a better understanding of tolerance, as well as better immunopathology and conservation techniques 1,4 .…”

“…In vascular surgery, endovascular techniques remain one of the most important choices when planning revascularization. Furthermore, we must also remember that autologous tissue in optimal conditions have been and will be over other types of graft because of its demonstrated superiority in term of patency rate and limb salvage rate 1 .…”