[Immunosuppression in the treatment of vascular prosthesis infection with arterial transplantation].
OBJECTIVE
The purpose of this study is to evaluate the use of immunosuppression in treatment of prosthetic graft infections with arterial transplantation.


METHODS
In this paper 29 cases of the massive aorto-ilio-femoral graft infection treated by the replacement of infected prosthesis with arterial homograft are presented. The arterial allograft was stored with application of cold ischemia method in preservation solution at 4 degrees C. During the follow up period the patients were divided into two groups: group received immunosuppressive regimen after surgery (n = 16) and group without immunosuppression (n = 13). The Duplex-Doppler ultrasound, the scintigraphy with use of Technetium-labeled leukocytes, bacteriological and antigenic examination and blood levels of Cyclosporin A were used in the diagnostic trial of infection and of the healing process of the homograft. In both groups there was performed evaluation of arterial wall by using the scanning electron microscopy.


RESULTS
In the group with immunosuppression no complications due to the homograft's wall degradation and deficiency of cell mediated immunity in infections were noticed. In the group without immunosuppression there were observed complications related to the impairment of the allograft wall: in 3 cases--the graft rupture, in 2 cases--the graft true aneurysm and homograft thrombosis in 3 cases.


CONCLUSIONS
The use of immunosuppression in transplantation of artery produces increase in survival rate and improves function of arterial graft.
Pupka
Artur
A
Katedra i Klinika Chirurgii Naczyniowej Ogólnej i Transplantacyjnej Akademii Medycznej we Wrocławiu. apupka@chirn.am.wroc.pl
Skóra
Jan
J
Janczak
Dariusz
D
Patrzałek
Dariusz
D
Ruciński
Artur
A
Korta
Krzysztof
K
Stepiński
Piotr
P
Szyber
Piotr
P
D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology / Q000637:transplantation*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine