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Cryopreserved arterial homografts: Preliminary study

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Annals of Vascular Surgery

Abstract

The use of arterial or venous allografts for vascular reconstruction was first reported in 1951, but long-term results have been disappointing. Rejection and inappropriate methods of preservation are the main reasons for failure. A successful solution to this problem could be achieved by programmed cryopreservation with cryoprotectant. Our study had two aims: to define the biomechanical properties of cryopreserved arterial allografts and to study their histologic appearance. Arteries were removed as part of a protocol for multiorgan harveting for transplantation. Cryopreservation was performed within the first 24 hours after harvesting. Programmed cryopreservation with 15% dimethyl sulfoxide (cryoprotectant) was used. Mechanical testing was done immediately after thawing. Two groups were tested: a control group of fresh aortas and a group of cryopreserved aortas. Axial and circumferential strips were tested. High strain modulus and stress and strain characteristics were calculated for each strip. There was no statistically significant difference between the mechanical properties of fresh and cryopreserved human descending thoracic aortas. Biochemical tests were performed in the preservative solution at 1 and 7 days in both groups. There was no statistically significant difference between the two groups at day 1 or day 7 (p > 0.05). Histologic studies before and after arterial cryopreservation included standard and electron microscopy and showed that arteries had normal structure after cryopreservation. These results confirm that programmed cryopreservation with cryoprotectant does not alter the molecular or geometric configuration of collagen or elastic fibers. Endothelial cells were still present; however, their viability and function were not assessed. The results of our studies have encouraged us to use cryopreserved arterial allografts for clinical application, and to date 27 patients have received cryopreserved arterial allografts. Definitive results including histologic and immunologic findings will be reported in the future when the length of follow-up is adequate.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, North University Hospital, 42055, St. Etienne Cedex 2, France

    Jean-Paul Gournier MD, Mustapha Adham MD, Jean-Pierre Favre MD, Michel Raba MD, Brigitte Bancel MD, Jean-Claude Lepetit MD & Xavier Barral MD

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  1. Jean-Paul Gournier MD
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  2. Mustapha Adham MD
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  3. Jean-Pierre Favre MD
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  4. Michel Raba MD
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  5. Brigitte Bancel MD
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  6. Jean-Claude Lepetit MD
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  7. Xavier Barral MD
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Gournier, JP., Adham, M., Favre, JP. et al. Cryopreserved arterial homografts: Preliminary study. Annals of Vascular Surgery 7, 503–511 (1993). https://doi.org/10.1007/BF02000144

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