Cold-Stored Venous Allografts In Different Preserving Solutions: A Study On Changes In Vein Wall Morphology

Area of Science:

• Vascular Surgery
• Tissue Preservation
• Biomaterials Science

Background:

• Saphenous veins are crucial bypass conduits in vascular reconstructions.
• Long-term cold storage of these veins necessitates effective preservation solutions.
• Maintaining vein wall integrity and function is vital for successful grafting.

Purpose of the Study:

• To compare the efficacy of various preservation solutions on saphenous vein morphology during extended cold storage.
• To evaluate the impact of different solutions on endothelial function retention.

Main Methods:

• Saphenous vein samples from 29 patients were stored at 4°C in formalin, isotonic saline with heparin and antibiotic (ISHA), phosphate-buffered saline (PBS), glutaraldehyde + PBS, or Custodiol.
• Histological analysis assessed vein wall changes up to 35 days.
• Immunohistochemistry detected endothelial nitric oxide synthase (eNOS) to evaluate endothelial function.

Main Results:

• Formalin preserved morphology but showed weak eNOS staining.
• PBS and ISHA poorly preserved vein wall morphology, with PBS eNOS staining decreasing significantly.
• Custodiol and glutaraldehyde offered better morphology preservation than ISHA and PBS after day 5.
• ISHA demonstrated stronger eNOS staining at day 35 compared to PBS, indicating better functional retention.

Conclusions:

• Custodiol and glutaraldehyde excel in preserving saphenous vein morphology during cold storage.
• Isotonic saline with heparin and antibiotic (ISHA) shows the most promise for retaining endothelial function, evidenced by eNOS staining, despite suboptimal morphological preservation.
• The choice of preservation solution involves a trade-off between morphological integrity and functional capacity.