Vascular allografts for clinical application in Europe: assessment of 30 years of experience with vascular tissue banking in Brussels

Abstract

Vascular tissue banking has been carried out in Brussels for over 30 years in compliance with EU and Swiss tissue banking regulations. A total of 2.765 vascular tissue donations were performed in Belgian, French, Netherlands and Suisse transplant centres: 547(20%), 1.013(37%) and 1.205(43%) during the first, second and third periods, respectively. 85% and 18% increase in donations during the second and third decades compared to previous one, were remarkable. Of the 7.066 evaluated vascular tissues, 2.407(227, 921 and 1.259) were discarded (34.1%), whereas 4.659(523, 1.861 and 2.275) accepted (65.9%) during the respective period. Of the 92 donated veins, 44(47.8%) were discarded and 48(52.2%) accepted. Allografts available for clinical application were stored in vapours of liquid nitrogen. A total of 4.636 allografts were delivered and transplanted for cases of infection (58%), critical limb ischaemia (16%) and congenital cardiac surgery (15%). Thirty veins were implanted. The progressive increases in donations of 20%, 37% and 43% and in transplantations of 20.8%, 34.6% and 45% during the first, second and third periods, respectively, were remarkable. Complications were reported after transplantation and these included acute rejection of two femoral arteries one month after transplantation. We conclude that the donation and transplantation of cryopreserved vascular allografts was stable with a progressive increase over time. Allografts were used predominantly for the treatment of infection, limb salvage for critical ischaemia and for neonates and infants with congenital cardiac malformation. Immune related rejection was observed. This should be a subject of future investigation.

Effects of different preservation schemes on isolated rat artery

“…With the development of organ donation, the sources of allogeneic vessels have been increasingly abundant. Considering its advantages in adequate sources, matched vascular diameter, well biocapacity, and high short‐term and long‐term patency rate, the application of allogeneic vessels in vascular reconstruction is promising 8,9 …”

“…Considering its advantages in adequate sources, matched vascular diameter, well biocapacity, and high short‐term and long‐term patency rate, the application of allogeneic vessels in vascular reconstruction is promising. 8 , 9 …”

“…Considering its advantages in adequate sources, matched vascular diameter, well biocapacity, and high short-term and longterm patency rate, the application of allogeneic vessels in vascular reconstruction is promising. 8,9 However, fresh allogeneic vessels are not always available in clinical practice, urging the necessity of adopting proper preservation schemes to store these vessels for clinical needs effectively. An ideal vascular condition and proper procedure for vascular preservation might influence surgical safety and patients' prognosis directly.…”