title: Experimental results and clinical impact of using autologous rectus fascia sheath for vascular replacement.
abstract: Vascular complications are major causes of graft failure in liver transplantation. The use of different vascular grafts is common but the results are controversial. The aim of this study was to create an 'ideal' arterial interponate for vascular replacements in the clinical field. An autologous, tubular graft prepared from the posterior rectus fascia sheath was used for iliac artery replacement in dogs for 1, 3, 6 and 12 months. Forty-one grafts were implanted and immunosuppression was used in separate groups. The patency rate was followed by Doppler ultrasound. Thirty-seven grafts remained patent, 2 cases with thrombosis and 2 cases with stenosis occurred. There was no evidence of necrosis or aneurysmatic formation. The histological analysis included conventional light microscopic and immunohistochemical examinations for CD34 and factor VIII. The explanted grafts showed signs of arterialisation, appearance of elastin fibres, and smooth muscle cells after 6 months. Electron microscopy showed intact mitochondrial structures without signs of hypoxia. In conclusion, the autologous graft presents acceptable long-term patency rate. It is easy to handle and the concept of beneficial presence of the anti-clot mesothelium until endothelialisation seems to work. The first clinical use was already reported by our group with more than 2 years survival.
authors.affiliation: Transplantation and Surgical Department, Semmelweis University, H-1082 Budapest, Baross u. 23-25, Hungary. kobori@trans.sote.hu
authors.forename: László
authors.initials: L
authors.lastname: Kóbori
authors.forename: Tibor
authors.initials: T
authors.lastname: Németh
authors.forename: Péter
authors.initials: P
authors.lastname: Nagy
authors.forename: Gábor
authors.initials: G
authors.lastname: Dallos
authors.forename: Péter
authors.initials: P
authors.lastname: Sótonyi
authors.forename: Imre
authors.initials: I
authors.lastname: Fehérvári
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
authors.forename: Dénes
authors.initials: D
authors.lastname: Görög
authors.forename: Attila
authors.initials: A
authors.lastname: Patonai
authors.forename: Katalin
authors.initials: K
authors.lastname: Monostory
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
authors.forename: Eniko
authors.initials: E
authors.lastname: Sárváry
authors.forename: János
authors.initials: J
authors.lastname: Fazakas
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Gerlei
authors.forename: Tamás
authors.initials: T
authors.lastname: Benko
authors.forename: László
authors.initials: L
authors.lastname: Piros
authors.forename: Jeno
authors.initials: J
authors.lastname: Járay
authors.forename: Koert P
authors.initials: KP
authors.lastname: De Jong
mesh_terms: D000818:Animals; D004285:Dogs; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000517:prevention & control; D007083:Iliac Artery / Q000637:transplantation*; D007165:Immunosuppression Therapy; D016031:Liver Transplantation; D014463:Ultrasonography; D014654:Vascular Patency / Q000502:physiology*