Depopulated bovine ureteric xenograft for complex haemodialysis vascular access.
OBJECTIVE
To assess performance of a de-cellularised bovine ureter vascular graft for haemodialysis in patients for whom conventional access was not possible.


METHODS
The Syner Graft Vascular Graft Model 100 (SGVG 100) is a bovine ureter modified by a tissue-engineering depopulation technology and uniquely it is not chemically cross-linked. SGVG 100 was implanted in patients with a failed fistula or vascular access grafts. Graft patency was the primary outcome; secondary outcomes included adverse events and associated treatments.


RESULTS
25 SGVG 100 were implanted in 23 patients; mean age was 59+/-14 years. Mean follow-up was 370 days. The mean time to occlusion (19 events) was 215+/-141 days with patency re-established in 14 of 18 surgical interventions. Thirty angioplasties were performed on 14 SGVG 100 for luminal/anastomotic stenosis. Two grafts demonstrated areas of dilation; however, both grafts continue to be usable at last reported follow-up (930 and 602 days) with no further changes in graft size. Primary patency, assisted primary patency, secondary patency, and freedom from infection were 29, 45, 81, and 95% at 1 year, respectively.


CONCLUSIONS
This report demonstrates SGVG 100 is a stable vascular access conduit, providing a suitable graft alternative when autologous vein is not available.
Darby
C R
CR
Oxford Transplant Centre, Headington, Oxford, UK. chris.darby@orh.nhs.uk
Roy
D
D
Deardon
D
D
Cornall
A
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001705:Bioprosthesis / Q000009:adverse effects; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D001916:Brachial Artery; D002417:Cattle; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012086:Reoperation; D023822:Tissue Engineering; D014513:Ureter; D014654:Vascular Patency