Human umbilical cord vein for vascular replacement: preliminary report and observations.

Human umbilical cord vein allografts (HUCVAG) were prepared by sequential treatment of fresh cords with 95 percent ethanol and 1.3 percent dialdehyde starch. Twenty-six of 30 canine aortic implants of fully treated grafts were patent at the end of 8 months. Among 25 aortic interpositions of untreated and 70 percent ethanol-treated grafts, the mean survival was 13 and 34 days, respectively. Five of ten 70 percent ethanol:1.3 percent dialdehyde starch-treated implants remained patent for 8 months. Graft failure was attributed to incomplete antigenic suppression manifested by rejection changes, including thrombosis, anastomotic disruption, aneurysm formation, and intimal degeneration. HUCVAG has been used in five patients who required femoropopliteal bypass. Of three successful revascularizations, two remain patent beyond 8 months without aneurysm formation. These results suggest that the processed, valveless, unbranched HUCVAG, in unlimited supply, may serve as an available alternative in the absence of a suitable saphenous vein.