Uruguayan experience with cryopreserved arterial homografts

INTRODUCTION

We analyzed the Uruguayan experience with cryopreserved arterial homografts. We studied 55 medical records in the period from June 9, 2000 to April 7, 2007, including 41 from males and 14 from females, ranging from 36-78 years of age. The clinical indications were as follows: Group 1, revascularization of infrainguinal atherosclerotic occlusive disease by bypass due to the lack of availability of a suitable vein (n = 35); Group 2, substitution of an infected prosthetic grafts (n = 15); and Group 3, arteriovenous fistula (AVF) after failure of previous prosthetic loops by repeated thrombosis and/or infection in the absence of a vein (n = 5).

RESULTS

Among Group 1, primary and secondary patency rates were 61% and 71%, respectively at 1 year with 15 complications, 3 infections, 8 thromboses, 2 aneurysms, 1 homograft degradation, and 1 death related to surgery. Among Group 2, the primary and secondary patency rates were 71% and 79%, respectively, at 1 year with 6 patients experiencing complications. Group 3 did not have complications with a primary patency rate of 67% at 1 year.

CONCLUSIONS

The use of cryopreserved arterial homografts is a valid, accessible, and safe alternative in complicated vascular situations. In our country, it is a technology to consider for patients with critical limb ischemia, when the risk of a major amputation is high and it is not possible to have a suitable vein or prosthetic bypass. It can be an excellent alternative for the substitution of infected synthetic bypasses, especially to substitute in situ for an infected aortic graft.

Progress of National Multi-tissue Bank in Uruguay in the International Atomic Energy Agency (IAEA) Tissue Banking Programme

The transplant law of 1971 based on informed consent, allows people to register their willingness to be a donor upon death. Since 1978 the governmental Institution, the National Bank of Organs and Tissues (BNOT), have been regulated the organ and tissue donation. Important progress was implemented in the BNOT and specially in the National Multi-tissue Bank (NMTB). Since 2001 with the participation in the IAEA Tissue Banking Programme, Quality System Management has been implemented in the NMTB. New bio-production for radiosterilized tissues for the first time and improved procedures were carried out. As a result an increased production of high-quality tissues was obtained and distributed for clinical use.