The use of homologous veins in arterial reconstructions. An experimental study.

In order to evaluate under what conditions the use of venous homografts could yield the best results. 230 arterial reconstructions were performed in mongrel dogs bypassing their ligated femoral arteries. Cumulative 6-month patency-rates were: Group 1: Prosthetic materials: a) Dacron grafts: 48%, b) PTFE grafts: 53%. Group 2: Fresh veins: a) autografts: 100%, b) allografts: 37%, c) allografts treated with cyclosporin 4 mg/kg.day for one month: 74% (100% after one month). Group 3: Veins preserved in saline at 4 degrees C. for one month: a) autografts: 44%, b) allografts: 34%. Group 4: Frozen veins preserved in saline at -70 degrees C. for one month: a) autografts: 58%, b) allografts: 47%. Group 5: Veins preserved in glutaraldehyde 0.25% for one month: a) autografts: 26%, b) allografts: 22%. Group 6: Veins preserved in 15% DMSO in Hanks solution at -160 degrees C for one month: a) autografts: 77%, b) allografts: 35%, c) allografts treated with cyclosporin 4 mg/kg.day for one month: 72%, d) allografts treated with methylprednisolone 1 mg/kg.day for one month: 38%, e) allografts treated with cyclosporin 4 mg/kg and methylprednisolone 1 mg/kg daily for one month: 83%. Fresh veins and veins preserved in 15% DMSO at -160 degrees C. are viable but immunologically active grafts. In allografts rejection phenomena cause a relatively high occlusion rate which, however, can be prevented with low dose cyclosporin. The optimal duration of immunosuppressive therapy remains to be determined. Veins stored at 4 degrees C or at -70 degrees C are not viable and only weakly antigenic. Their results are not better than those obtained with prosthetic material.(ABSTRACT TRUNCATED AT 250 WORDS)