EFFECTS OF CRYOPRESERVATION UPON VEIN FUNCTION IN-VIVO

This review covers experimental and clinical experiences with transpla ntation of allogeneic veins processed by slow rate cooling with 2.5% ( WN) chondroitin sulfate and 1 M dimethylsulfoxide. These results are c ontrasted with the results obtained using dimethylsulfoxide alone. The short-term patency of experimental autologous (100%) and allogeneic ( 7-100%) cryopreserved veins may be attributed to the combination of '' no-touch'' procurement techniques employing the smooth muscle relaxant papaverine, the chondroitin sulfate preservation method, and recipien t therapy. Explanted autografts retain many cell and tissue functions. In contrast, explanted allografts demonstrate short-term loss of endo thelial cells and smooth muscle function, both of which subsequently r eturn. Clinically there have been positive short-term correlations bet ween good initial runoff from the graft site and 1-year patency (68-74 %) and limb salvage (94%) rates. In contrast, grafts with poor initial runoff, composite grafts, or grafts requiring secondary reconstructio n resulted in lower 1-year patency (40-44%) and limb salvage (64%) rat es. More experience, larger study groups, and longer follow-up are nec essary to evaluate the clinical performance of chondroitin sulfate-pre served grafts. In the meantime, chondroitin sulfate-preserved veins ar e reserved for coronary artery bypass or peripheral bypass patients in the absence of suitable autologous vessels. (C) 1994 Academic Press, Inc.