title: Cryopreserved arterial allograft reconstruction for peripheral graft infection.
abstract: OBJECTIVE
  This prospective, observational study evaluated the safety and efficacy of cryopreserved arterial allograft reconstruction in the management of major peripheral arterial graft infections.
  
  
  METHODS
  From April 1996 to May 2003, data from patients with major peripheral arterial graft infection who underwent graft excision and cryopreserved arterial allograft reconstruction were prospectively collected. Arterial allografts were harvested from multiple organ donors and cryopreserved at -80 degrees C. The patients were observed for survival, limb salvage, persistence or recurrence of infection, and allograft patency. The results were calculated with the Kaplan-Meier method.
  
  
  RESULTS
  During the 7-year study period, 17 patients (14 men, 3 women; mean age, 68 years) with major peripheral graft infection underwent graft excision and cryopreserved arterial allograft reconstruction. Eight patients (47%) had systemic sepsis, 5 (29%) had acute ischemia at the time of the allograft reconstruction, and 9 (53%) had experienced anastomotic rupture. Allograft reconstruction was performed as an emergency procedure in 7 patients (41%). There were no perioperative deaths or early amputations. Two patients had allograft ruptures in the groin during the early postoperative period. The mean follow-up period was 34 months (range, 8 to 80 months). There was no persistent or recurrent infection, and none of the patients received long-term (>3 months) antibiotic therapy. Reoperation for allograft revision, excision, or replacement was performed in 2 patients. The 18-month primary and secondary allograft patency rates were 68% and 86%; the overall limb salvage rate was 82% at 2 years.
  
  
  CONCLUSIONS
  Our experience with cryopreserved arterial allograft in the management of major peripheral bypass graft infection suggests that this technique seems to be a useful option for treating one of the most dreaded vascular complications.
authors.affiliation: Service de Chirurgie Vasculaire et Thoracique, Hôpital Beaujon (AP-HP), 100 Boulevard du Général Leclerc, 92110 Clichy, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Castier
authors.forename: Fady
authors.initials: F
authors.lastname: Francis
authors.forename: Pierre
authors.initials: P
authors.lastname: Cerceau
authors.forename: Mathieu
authors.initials: M
authors.lastname: Besnard
authors.forename: Jérome
authors.initials: J
authors.lastname: Albertin
authors.forename: Laurent
authors.initials: L
authors.lastname: Fouilhe
authors.forename: Olivier
authors.initials: O
authors.lastname: Cerceau
authors.forename: Pierre
authors.initials: P
authors.lastname: Albaladejo
authors.forename: Guy
authors.initials: G
authors.lastname: Lesèche
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000637:transplantation*; D015925:Cryopreservation; D006801:Humans; D007239:Infections / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D014184:Transplantation, Homologous; D014652:Vascular Diseases / Q000601:surgery*; D014654:Vascular Patency