Cold-stored venous allografts in the treatment of critical limb ischaemia.
OBJECTIVE
To assess the outcome of cold-stored venous allografts in critically ischemic limbs in patients with no ipsilateral autogenous greater saphenous vein.


METHODS
A non-randomised, retrospective, single-center study.


METHODS
From September 2000 to June 2006, 46 cold-stored venous allografts obtained during multiorgan harvest were implanted into 44 critically ischaemic limbs of 43 patients. The indication for reconstructions was rest pain (24%) or tissue lost (76%). Sixty-seven percent of procedures were performed as secondary reconstructions, and 61% of veins were anastomosed to tibial or pedal arteries. Thirty-seven percent of patients received prednisone, and 46% tacrolimus as postoperative immunosuppressive therapy. Mean patient follow-up period was 13.3 months (range 1 week to 60 months).


RESULTS
The secondary patency rate for the cohort was 83+/-5.6% at 1 month, 64+/-8.2% at 6 months, 57+/-10.0% at 12 months and 46+/-10.7% at 24 months. Limb salvage rate was 96+/-3.1% at 1 month, 78+/-6.9% at 6 months, 71+/-8.1% at 12 months and 50+/-11.8% at 24 months.


CONCLUSIONS
Cold-stored venous allografts are an alternative conduit for limb salvage procedures when ipsilateral autogenous vein is unavailable.
Matia
I
I
Department of Transplant Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. ivmi@medicon.cz
Janousek
L
L
Marada
T
T
Adamec
M
M
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D015925:Cryopreservation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D023821:Limb Salvage / Q000706:statistics & numerical data; D035002:Lower Extremity / Q000098:blood supply* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014654:Vascular Patency