title: Cryopreserved arterial allografts in the treatment of prosthetic graft infections.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of cryopreserved arterial allografts in the management of prosthetic graft infection.
  
  
  METHODS
  Over a 5-year period 45 patients with infection of prosthetic vascular grafts were treated. There were 39 intra-abdominal infected grafts (group I) and six extra-abdominal infected grafts (group II). Treatment consisted of total graft removal and in situ or extra-anatomic implantation of cryopreserved arterial allografts. Six patients were operated on as an emergency. Four patients presented with aorto-enteric fistula. Follow-up ranged from 30 to 78 months.
  
  
  RESULTS
  There were six in-hospital deaths and two additional patient deaths during follow-up, yielding an overall mortality rate of 18%. Six patients died due to complications directly related to infection or insertion of an allograft. Combined short and long-term mortality rate was much higher in patients operated on as an emergency (67%) compared to elective cases (11%). Patients with aorto-enteric fistula had the highest mortality rate (75%). Primary and secondary 3-year allograft patency rates for group I were 84 and 94%, respectively and for group II were 60 and 80%, respectively.
  
  
  CONCLUSIONS
  Aortic allografts are useful in the treatment of infection of major vascular prosthetic grafts, except for patients with aorto-enteric fistula. Patients with infection of the prosthetic graft should be promptly assessed for graft removal, since results of elective surgery are much better than results of emergency procedures.
authors.affiliation: Department of Vascular Surgery, Medical University, Poznań, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Gabriel
authors.forename: F
authors.initials: F
authors.lastname: Pukacki
authors.forename: Ł
authors.initials: Ł
authors.lastname: Dzieciuchowicz
authors.forename: G
authors.initials: G
authors.lastname: Oszkinis
authors.forename: P
authors.initials: P
authors.lastname: Checiński
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001018:Aortic Diseases / Q000209:etiology / Q000601:surgery; D001158:Arteries / Q000637:transplantation*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D015925:Cryopreservation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000601:surgery*; D013203:Staphylococcal Infections / Q000601:surgery*; D013997:Time Factors; D014184:Transplantation, Homologous; D016157:Vascular Fistula / Q000209:etiology / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents