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Ten-year experience with cryopreserved vascular allografts in the Croatian Cardiovascular Tissue Bank
M Golemovic1, M Skific1, D Haluzan2
1Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia.
Insights
The Croatian Cardiovascular Tissue Bank processed vascular allografts for transplantation. While aortic reconstructions showed good outcomes, peripheral reconstructions faced significant reinfection rates, indicating a need for further study.
Area of Science:
- Cardiovascular Surgery
- Tissue Banking
- Transplantation Immunology
Background:
- The Croatian Cardiovascular Tissue Bank (CTB) was established in 2011 to manage cardiovascular allografts.
- CTB activities include processing, quality control, storage, and distribution of heart valves and blood vessels.
Purpose of the Study:
- To present the vascular tissue activities of CTB.
- To retrospectively evaluate the clinical outcomes of vascular allograft use at University Hospital Centre Zagreb.
Main Methods:
- Analysis of vascular allografts (VAs) referred to CTB between June 2011 and July 2021.
- Evaluation of VA quality, discard reasons, and transplantation outcomes.
- Categorization of patients into aortic and peripheral reconstruction groups.
Main Results:
- Out of 90 referred VAs, 54% met quality standards; main discard reasons were morphology and contamination.
- 42 VAs were released, with 37 used in 27 surgeries, primarily for prosthetic graft/stent infections.
- Aortic reconstruction group: 58% had no graft-related complications. Peripheral reconstruction group: significant reinfection rates observed.
Conclusions:
- Vascular allografts show potential efficacy, particularly in aortic reconstructions.
- Peripheral reconstructions with VAs are associated with a high incidence of reinfection.
- Further research with larger cohorts and comparative analyses is needed to confirm efficacy and optimize treatment strategies.
Abstract:
The Croatian Cardiovascular Tissue Bank (CTB) was established in June 2011. Activities managed by CTB are processing of heart valves and blood vessels, as well as quality control, storage, medical release and distribution of allografts. The aim of this report is to present CTB's vascular tissue activities and retrospectively evaluate the outcomes of their use in the University Hospital Centre Zagreb. Between June 2011 and July 2021, 90 vascular allografts (VAs) from 55 donors after brain death were referred to CTB. Only 54% of VAs met the tissue quality requirements while 46% of tissues were discarded. The most frequent reasons for discard were unacceptable morphology and initial microbiological contamination. Altogether 42 VAs were released for transplantation and 37 of them were used in 27 surgical procedures. The most common indication for surgery was prosthetic graft or stent infection. According to the anatomic position of vascular reconstruction, patients were divided in the aortic and peripheral reconstruction group. A total of 23 patients were treated. In the aortic reconstruction group 58% of patients did not experience any graft-related complications. In the group of patients who underwent peripheral reconstruction significant incidence of reinfection was observed highlighting it as a major graft-related complication. Despite the small patient groups and limited duration of follow-up, presented clinical outcomes provide valuable information on the efficacy of vascular allografts. Additional clinical results collected on a larger patient groups and comparison to other reconstructive treatment options are necessary.
