The fate of human umbilical vein grafts as an infrarenal aortic substitute in monkeys.
The literature contains conflicting reports about the potential value of the processed human umbilical vein graft as an arterial substitute. With a view to a better understanding of the ultimate fate of this device, a series of long-term implantation was undertaken with a nonhuman primate model. Dardik Biografts were implanted as an infrarenal aortic substitute in 13 monkeys. Nine were put to death following complications after post-operative periods ranging from 3 months to 3 years, while four animals remain alive. No calcification or lipid infiltration was found, presumably because the animals were healthy. The patency rate was poor because of complications associated with thrombotic deposits and thinning of the graft wall after implantation, which led to stenosis and fibrous hyperplasia along the anastomoses. The external polyester mesh was found to encourage external tissue proliferation, which could not prevent the graft from dilating since it contained neither elastin nor smooth muscle cells. Because the places where the graft had been damaged before or during processing were the sites of thrombotic accumulation and initial collagen degeneration, it is essential to use only defect-free material. As a consequence the long-term durability of this graft continues to be questioned.
D000818:Animals; D001013:Aorta, Thoracic / Q000601:surgery*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000473:pathology; D006084:Graft Rejection; D006801:Humans; D008252:Macaca fascicularis; D008253:Macaca mulatta; D008297:Male; D008954:Models, Biological; D012077:Renal Artery / Q000601:surgery*; D014471:Umbilical Veins / Q000473:pathology / Q000637:transplantation*