Cryopreserved aortic allograft replacement of infected prosthetic grafts in man: processing and clinical results

Aortic allografts preserved at 4 degrees C have been used successfully for the replacement of infected prosthetic grafts, but have a limited storage duration and this does not allow for rigourous security of the allograft. Original cryopreservation protocol has been developed, characterized by the use of polyethylene glycol 20,000 30 g/l associated with 12.5% DMSO, high concentration of antibiotics (lincomycin 300 mg/l, vancomycin 125 mg/l), controlled freezing rate, and storage in the vapour phase of liquid nitrogen (-150 degrees C). Cryopreserved arterial allografts were used for the replacement of infected prostheses in 22 patients. In 2 patients, allograft-related dysfunction was observed, 3 patients died in the early postoperative period from non-allograft-related causes, and, 17 patients were cured of infection without any dysfunction of the allograft. These results are comparable to replacement by fresh allograft, but cryopreservation allows for better microbiological security, long-term storage, and, thus, better management of the available allografts.