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Arterial homografts

A D Callow1

  • 1Whitaker Cardiovascular Institute, Boston University Medical Center, University Hospital, Massachusetts, USA.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|October 1, 1996
PubMed
Summary
This summary is machine-generated.

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Arterial allografts show limited success due to rejection and loss of cell function. They are best for critical revascularization or infected fields, not routine use.

Area of Science:

  • Vascular Surgery
  • Transplantation Immunology

Background:

  • Arterial allografts (homografts) were early arterial substitutes with limited clinical success.
  • Rejection and loss of cellular function were major limitations of early allografts.
  • Synthetic grafts largely replaced allografts due to their limitations.

Observation:

  • Renewed interest in allografts stems from re-do procedures and infected fields.
  • Graft procurement and preservation methods do not fully restore cellular function or eliminate antigenicity.
  • Immune suppression for allografts in ischemic limbs presents significant biologic and economic costs.

Findings:

  • Allografts demonstrate antigenicity and do not preserve endothelial or smooth muscle cell function.
  • Current immune suppression costs are unjustifiable for routine allograft use in ischemic limbs.

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  • Xenotransplantation may offer future alternatives with targeted complement system inhibition.

    • Implications:

    • Allografts are currently acceptable for critical revascularization, urgent trauma, or when immunosuppression is contraindicated.
    • Allografts are not recommended for claudication relief, below mid-calf use, or where synthetics are superior.
    • Future research into xenotransplantation may provide less immunogenic alternatives.