Effects of cryopreservation upon vein function in vivo.
This review covers experimental and clinical experiences with transplantation of allogeneic veins processed by slow rate cooling with 2.5% (W/V) chondroitin sulfate and 1 M dimethylsulfoxide. These results are contrasted with the results obtained using dimethylsulfoxide alone. The short-term patency of experimental autologous (100%) and allogeneic (70-100%) cryopreserved veins may be attributed to the combination of "no-touch" procurement techniques employing the smooth muscle relaxant papaverine, the chondroitin sulfate preservation method, and recipient therapy. Explanted autografts retain many cell and tissue functions. In contrast, explanted allografts demonstrate short-term loss of endothelial cells and smooth muscle function, both of which subsequently return. Clinically there have been positive short-term correlations between good initial runoff from the graft site and 1-year patency (68-74%) and limb salvage (94%) rates. In contrast, grafts with poor initial runoff, composite grafts, or grafts requiring secondary reconstruction resulted in lower 1-year patency (40-44%) and limb salvage (64%) rates. More experience, larger study groups, and longer follow-up are necessary to evaluate the clinical performance of chondroitin sulfate-preserved grafts. In the meantime, chondroitin sulfate-preserved veins are reserved for coronary artery bypass or peripheral bypass patients in the absence of suitable autologous vessels.
Brockbank
K G
KG
CryoLife, Inc., Marietta, Georgia 30067.
D000818:Animals; D002809:Chondroitin Sulfates; D015925:Cryopreservation / Q000379:methods*; D003451:Cryoprotective Agents; D004121:Dimethyl Sulfoxide; D006801:Humans; D007165:Immunosuppression Therapy; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D013924:Thrombophlebitis / Q000517:prevention & control; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014680:Veins / Q000276:immunology / Q000503:physiopathology / Q000637:transplantation
D003451:Cryoprotective Agents; D010975:Platelet Aggregation Inhibitors; D002809:Chondroitin Sulfates; D004121:Dimethyl Sulfoxide