Augelli N V, Lupinetti F M, el Khatib H, Sanofsky S J, Rossi N P
Department of Surgery, University of Iowa College of Medicine, Iowa City 52242.
Transplantation. 1991 Sep;52(3):466-70. doi: 10.1097/00007890-199109000-00014.
Autogenous saphenous vein is the preferred conduit for many cardiovascular operations. Attempts to use allograft veins for arterial reconstruction have had poor results. To define circumstances under which allograft veins might prove to be acceptable vascular conduits, dogs underwent femoral artery bypass using reversed saphenous veins. Veins were transplanted fresh or after cryopreservation. Group I dogs received a fresh autograft to replace one femoral artery (group I F) and a cryopreserved (CP) autograft (group I C) to replace the other. Group II dogs received fresh allograft veins, and group III received CP allograft veins, neither group receiving additional treatment. Group IV received fresh allograft veins and Group V received CP allograft veins; both groups received cyclosporine 15 mg/kg. Animals were maintained until grafts occluded or until six months elapsed. Patency was observed in all group I F grafts throughout the observation period. Six-month patency rates in the other groups were: group I C, 9/10 (P = NS vs. group I F); group II, 0/10 (P less than 0.01), group III, 0/10 (P less than 0.01), group IV, 1/10 (P less than 0.01), group V, 7/11 (P = NS). In a separate series of observations 10 cryopreserved allograft veins were implanted in 10 dogs that received CsA for 30 days. CsA was then discontinued. All of these grafts occluded within 30 days of discontinuing the CsA. Long-term patency of saphenous vein allografts was achieved only with the combination of cryopreservation and immunosuppression with continued CsA.
自体大隐静脉是许多心血管手术的首选管道。尝试使用同种异体静脉进行动脉重建的效果不佳。为了确定在何种情况下同种异体静脉可能被证明是可接受的血管管道，对狗进行了使用逆行大隐静脉的股动脉旁路移植术。静脉在新鲜状态或冷冻保存后进行移植。第一组狗接受新鲜自体移植以替换一条股动脉（第一组F），接受冷冻保存（CP）的自体移植以替换另一条股动脉（第一组C）。第二组狗接受新鲜同种异体静脉，第三组接受CP同种异体静脉，两组均未接受额外治疗。第四组接受新鲜同种异体静脉，第五组接受CP同种异体静脉；两组均接受15mg/kg的环孢素。动物维持到移植血管闭塞或6个月过去。在整个观察期内，第一组F的所有移植血管均保持通畅。其他组的6个月通畅率为：第一组C，9/10（与第一组F相比P=无显著性差异）；第二组，0/10（P<0.01），第三组，0/10（P<0.01），第四组，1/10（P<0.01），第五组，7/11（P=无显著性差异）。在另一系列观察中，将10条冷冻保存的同种异体静脉植入10只接受环孢素30天的狗体内。然后停用环孢素。所有这些移植血管在停用环孢素后30天内均闭塞。只有将冷冻保存与持续使用环孢素的免疫抑制相结合，才能实现同种异体大隐静脉的长期通畅。
