Successful Human Vascular Reconstructions with Long-Term Refrigerated Venous Homografts

Abstract

Fresh autologous vein grafts are commonly used for infrainguinal vascular reconstructions with good results. Previously we have confirmed the high viability index of homografts even after long-term storage at 4°C in tissue culture medium. In this clinical study, we have evaluated the in vivo efficiency of this storage method in humans with major peripheral graft infections. Between April 2006 and November 2008, data from patients who underwent graft excision and venous allograft reconstruction were collected prospectively (5 men, 2 women, mean age 68 years). Six patients had acute ischemia at the time of allograft reconstruction, while 3 had experienced anastomosis rupture. Allograft reconstruction was performed as an emergency procedure in 3 cases. The observed parameters included patient survival, limb salvage, persistence or recurrence of infection and allograft patency. In the follow-up period reoperation, excision or thrombectomy was necessary in 3 cases. There were no perioperative deaths, early amputations, persistent or recurrent infections. In conclusion, this study demonstrates the efficacy of long-term 4°C storage of venous allografts for revascularization in cases with peripheral bypass graft infection. We suggest that this technique is a useful option for graft preservation and propose a wide-scale introduction.

Successful Living Donor Liver Transplantation in Portomesenteric Thrombosis

“…The availability of vascular graft is essential for vascular reconstructions and the options include use of cryopreserved grafts, refrigerated grafts from deceased donor sources (13) and expanded polytetrafluoroethylene (ePTFE) graft (14). ePTFE has previously been used for anterior sector drainage but not for portal inflow.…”

Long-Term Results of Biological Grafts for Haemodialysis Vascular Access

“…Venous conduits from cadaveric donors have been used in small series of vessel replacement (7) and following extensive retroperitoneal tumour resection inferior vena cava (IVC), iliac vein and reversed femoral vein have been used and have shown good medium- to long-term results (8).…”

Frühergebnisse nach peripherem Gefäßersatz mit einer biosynthetischen Kollagenprothese bei Protheseninfektionen

“…Abschließende Erfahrungen über Langzeiteffekte stehen noch aus. Die Verwendung kalt gelagerter venöser Homografts bei Protheseninfektionen im femoralen und iliakalen Stromgebiet zeigen in einer Arbeit aus Ungarn gute Ergebnisse [16]. Bei der Verwendung frischer venöser Homografts fehlen Ergebnisse im Zusammenhang mit Infektionen.…”

“…Eine akzeptable Datenlage scheint hinsichtlich der Verwendung arterieller bzw. venöser Homografts vorzuliegen[14,[16][17][18]. Dennoch sind die hohen Anschaffungskosten sowie die immer schlechter werdende Verfügbarkeit nicht zuletzt aufgrund gesetzlicher Anforderungen für den Routineeinsatz problematisch[15].…”