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Clinical Experience with Cold-Preservation of Venous and Arterial Allografts. Long-Term Outcomes


Authors: I. Matia;  M. Adamec;  L. Janoušek;  K. Lipár;  T. Marada;  D. Klein;  P. Baláž;  M. Varga;  J. Chlupáč;  S. Rokošný
Authors‘ workplace: Klinika transplantační chirurgie, Institut klinické a experimentální medicíny, Praha, přednosta: prof. MUDr. Miloš Adamec, CSc.
Published in: Rozhl. Chir., 2010, roč. 89, č. 1, s. 45-54.
Category: Monothematic special - Original

Overview

Introduction:
Venous and arterial allografts extend the possibilities of peripheral arterial disease as well as vascular prosthesis infections treatment.

Material and methods:
Between 10/1997 and 1/2009 we used 112 allogeneic vessels (30 artieries, 82 veins) in 104 patients. Venous allografts were used for 82 reconstructions in 75 patients (M/F 41/34, aged 41–85 years, median 66 years) with critical limb ischemia and no suitable autogenous venous material.

Arterial allografts were used in 9 patients (M/F 8/1, aged 56–77 years, median 63 years) with aortoiliac prosthetic infections or mycotic abdominal aortic aneurysms and in 20 transplanted patients (M/F 11/9, aged 32–67 years, median 56 years) with aortoiliac atherosclerotic disease.

Results:
Patients survival rate after allovenous bypasses was 92% at 1 year and 78% at 3 years. Limb salvage rate was 67% at 1 year and 53% and 3 years. Secondary patency rate was 48% at 1 year and 27% at 3 years.

Patient survival rate after alloarterial bypasses was 86% at 1 year and 69% at 3 years. No signs of arterial grafts aneurysmal formation and no need for secondary intervention of any arterial reconstruction was observed during the follow up period in any patient after alloarterial transplantation.

Conclusions:
Cold-stored venous and arterial allografts are suitable alternative conduits for limb salvage procedures, vascular prosthesis infections as well as for arterial reconstructions in transplanted patients.

Key words:
venous allograft – arterial allograft – immnosuppression – transplantation – prosthetic infection


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Surgery Orthopaedics Trauma surgery

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