Peter H Lin1, William T Brinkman, Thomas T Terramani, Alan B Lumsden. 1. Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston VAMC, 2002 Holcomb Blvd. (112), Houston, TX 77030, USA. plin@bcm.tmc.edu
Abstract
BACKGROUND: One of the most feared complications of dialysis access is prosthetic arteriovenous (AV) graft infection, which is typically treated with AV graft removal followed by a staged dialysis graft placement elsewhere. Such a treatment approach often presents a challenge since many hemodialysis-dependent patients have limited venous access that may preclude a new AV graft or dialysis catheter placement. In this article, we review the management of AV graft infection using in situ cryopreserved human vein allografts. DATA SOURCES: Functional and antigenic characteristics as well as the clinical experience of cryopreserved human vein allograft in dialysis access are reviewed. Surgical technique of in situ cryopreserved human allograft placement for infected prosthetic AV graft is also described. CONCLUSIONS: Cryopreserved vein allograft is an acceptable graft conduit in difficult hemodialysis access situations. It offers surgeons the ability to deal with the infected graft in one operative procedure with low incidence reinfection and graft patency similar to conventional prosthetic graft replacement.
BACKGROUND: One of the most feared complications of dialysis access is prosthetic arteriovenous (AV) graft infection, which is typically treated with AV graft removal followed by a staged dialysis graft placement elsewhere. Such a treatment approach often presents a challenge since many hemodialysis-dependent patients have limited venous access that may preclude a new AV graft or dialysis catheter placement. In this article, we review the management of AV graft infection using in situ cryopreserved human vein allografts. DATA SOURCES: Functional and antigenic characteristics as well as the clinical experience of cryopreserved human vein allograft in dialysis access are reviewed. Surgical technique of in situ cryopreserved human allograft placement for infected prosthetic AV graft is also described. CONCLUSIONS: Cryopreserved vein allograft is an acceptable graft conduit in difficult hemodialysis access situations. It offers surgeons the ability to deal with the infected graft in one operative procedure with low incidence reinfection and graft patency similar to conventional prosthetic graft replacement.
Authors: Mehmet H Kural; Yuling Li; Juan Wang; Kaleb M Naegeli; Emmanuelle A Hugentobler; Laura E Niklason Journal: Circ Res Date: 2022-06-23 Impact factor: 23.213