THE USE OF HOMOLOGOUS VEINS IN ARTERIAL RECONSTRUCTIONS AN EXPERIMENTAL-STUDY

In order to evaluate under what conditions the use of venous homograft s could yield the best results, 230 arterial reconstructions were perf ormed in mongrel dogs bypassing their ligated femoral arteries. Cumula tive 6-month patency-rates were: Group 1: Prosthetic materials: a) Dac ron grafts: 48%, b) PTFE grafts: 53%. Group 2: Fresh veins: a) autogra fts: 100%, b) allografts: 37%, c) allografts treated with cyclosporin 4 mg/kg.day for one month: 74% (100% after one month). Group 3: Veins preserved in saline at 4-degrees-C. for one month: a) autografts: 44%, b) allograpfts: 34%. Group 4: Frozen veins preserved in saline at -70 -degrees-C for one month: a) autografts: 58%, b) allografts: 47%. Grou p: 5: Veins preserved in glutaraldehyde 0.25% for one month: a) autogr afts: 26% b) allografts: 22%. Group 6: Veins preserved in 15% DMSO in Hanks solution at -160-degrees-C for one month: a) autografts: 77%, b) allografts: 35%, c) allografts treated with cyclosporin 4 mg/kg.day f or one month: 72%, d) allografts treated with methylprednisolone 1 mg/ kg.day for one month: 38%, e) allografts treated with cyclosporin 4 mg /kg and methylprednisolone 1 mg/kg daily for one month: 83%. Fresh vei ns and veins preserved in 15% DMSO at -160-degrees-C. are viable but i mmunologically active grafts. In allografts rejection phenomena cause a relatively high occlusion rate which, however, can be prevented with low dose cyclosporin. The optimal duration of immunosuppressive thera py remains to be determined. Veins stored at 4-degrees-C or at -70-deg rees-C are not viable and only weakly antigenic. Their results are not better than those obtained with prosthetic material. Glutaraldehyde t reated veins are non-antigenic and not-viable but their results are wo rse than with any other method. In combination with low-dose cyclospor in for a limited period of time viable homologous saphenous veins seem an acceptable substitute when autologous saphenous vein is not availa ble. Storage in 15% DMSO at -160-degrees-C can be used for the creatio n of vein banks which offer the opportunity to have immunologically ma tched allografts available at any moment.