FRESH VENOUS ALLOGRAFTS IN PERIPHERAL ARTERIAL RECONSTRUCTION IN DOGS- EFFECTS OF HISTOCOMPATIBILITY AND OF SHORT-TERM IMMUNOSUPPRESSION WITH CYCLOSPORINE-A AND MYCOPHENOLATE MOFETIL

To date, no arterial substitute has been shown to be as effective as t he autologous saphenous vein in peripheral revascularization procedure s, In the present study, the venous allograft was evaluated as a vascu lar substitute in terms of patency and induction of host immune reacti vity, whether used in major histocompatibility complex-incompatible, m ajor histocompatibility complex-compatible, or immunosuppressed major histocompatibility complex-incompatible dogs. The immunosuppressive dr ug therapies were given for a period of 31 days, beginning 1 day befor e transplantation, and consisted of the use of cyclosporine A, mycophe nolate mofetil, or a combination of both, All histoincompatible allogr afts were thrombosed at 4 or 8 weeks after transplantation with antibo dy development and cell-mediated cytotoxicity in the graft, whereas hi stocompatible allografts showed late stenosis without immunologic reac tions directed toward donor cells, Given alone, neither cyclosporine A nor mycophenolate mofetil improved the overall patency of venous allo grafts; thrombosis occurred shortly after cessation of immunosuppressi on. Still, the cyclosporine A-mycophenolate mofetil combination therap y led to a 100% patency rate at 20 weeks after implantation and immune reactions were markedly reduced, This study shows that the fresh vein allograft is still an attractive and functional alternative to the au tologous saphenous vein if the host immunologic reactions are controll ed by cyclosporine A-mycophenolate mofetil immunosuppression.