title: The morphological evaluation of the homograft wall in an electron microscopic study.
abstract: Cases of massive purulent infection of vascular prosthesis are demonstrated in this study. Infected prosthesis was substituted by arterial homograft, harvested during multi-organ procurement, and stored by the cold ischaemia method. In the follow-up period, the patients were divided into two groups, those treated with immunosuppression (n = 16) and those treated without immunosuppressive drugs (n = 13). The patients underwent resurgery, during which a fragment of arterial wall was taken for electron microscopic examination. In the group with immunosuppression, the presence of the following structures was observed: endothelial cells, the intima, with a great number of elastic and collagen fibrils with fibrinogen inclusions, and active phagocyting myoblasts and myofibroblasts. In the group without immunosuppression electron microscopic examination showed the total destruction of the wall of the ruptured arterial homograft - absence of endothelium and sparse, damaged fibroblasts of the media or their degraded fragments, making a picture of cellular death. Morphological analysis of the arterial wall and the clinical state of the patient suggest the necessity of immunosuppressive treatment after fresh arterial homograft transplantation.
authors.affiliation: Department of Vascular, General and Transplantological Surgery, Medical University, Wrocław, Poland. apupka@chirn.am.wroc.pl
authors.forename: Artur
authors.initials: A
authors.lastname: Pupka
authors.forename: Barbara
authors.initials: B
authors.lastname: Dolińska-Krajewska
authors.forename: Piotr
authors.initials: P
authors.lastname: Barć
authors.forename: Jan
authors.initials: J
authors.lastname: Skóra
authors.forename: Piotr
authors.initials: P
authors.lastname: Szyber
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000187:drug effects / Q000637:transplantation / Q000648:ultrastructure*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D012086:Reoperation; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine