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Updated: Sep 29, 2026
A Modified Heterotopic Swine Hind Limb Transplant Model for Translational Vascularized Composite Allotransplantation (VCA) Research
Published on: October 14, 2013
Fresh arterial homograft transplantation: a novel concept for critical limb ischaemia
M Prager1, Th Hölzenbein, E Aslim
1Division of Vascular Surgery, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Introduction:
homografts have been used since the early days of vascular surgery, but have failed to provide long-term success. Arteries supplying organ transplants seldom show signs of biodegradation. We therefore introduced fresh arterial homograft repair with consecutive immunosuppression (ATX).
Aim:
to assess feasibility and clinical usefulness of ATX.
Setting:
university teaching hospital.
Material And Method:
conduits were harvested during multi-organ procurement and stored in Custodiol. Implantation followed immediately. Viability of the transplant was documented in all cases. Patients received immunosuppression for the duration of bypass function.
Results:
thirteen patients received ATX for critical limb ischaemia (M/F: 11/2, age: 62yr, previous revascularisations: 4.5 (1-8), median run-off index 5, previous organ transplant: n=2. Most bypasses were anastomosed to single tibial or pedal vessels. There was no early failure. Within an average follow up of 12 months there were 6 graft thromboses in 5 patients, successfully revised in 4. Three limbs were lost after 2, 5 and 6 months due to graft failure. Graft rejection was shown in 1 out of 3 explanted grafts.
Conclusion:
we report a concept, which may circumvent the problem of biologic graft degeneration. Limb salvage was possible in 75% at 12 months in otherwise difficult circumstances.
