Experimental Studies On Glycerol Preserved Vascular Allografts

"Autologous vein is the conduit of choice in patients with critical peripheral arterial disease who need a vascular reconstruction. However, autologous vein could be of inferior quality or used in prior surgery. Vascular allograft transplantation is an attractive alternative to prosthetic grafts in distal arterial reconstructions. Allograft transplantation requires a suitable preservation method. Previous methods were hampered by intima hyperplasia and aneurysm formation. Glycerol preservation proved to be superior in preservation and storage of skin allografts. The studies in this thesis evaluated the applicability of glycerol preservation of vascular allografts. A systematic review of clinical studies on different vascular allografts was performed. Heterogeneity among studies was high and excluded a formal meta-analysis. However, the overall graft performance of glutaraldehyde-preserved human umbilical vein allografts seemed superior to other allografts. The morphological and functional alteration in glycerol preserved allografts was examined in rat aorta segments. Breaking strength and bursting pressure experiments revealed preservation of biomechanical integrity of vessel wall after glycerol preservation. Applicability of glycerol allografts in vivo was evaluated in a rat aorta transplantation model. Cumulative graft patency rates were comparable to autografts and structural integrity of glycerol allografts was well preserved. Glycerol allografts were compared to autografts and allografts preserved in University of Wisconsin solution in a goat carotid artery transplantation model. Glycerol preservation proofed to be a feasible preservation method in a large animal model with decreased intimal hyperplasia and renewed functional capability."--Samenvatting auteur.