Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2022 Vol. 30 No 2

GENERAL & SPECIAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2022.2.186   |  

A.A. LYZIKOV, M.L. KAPLAN, D.A. ZINOVKIN, V.E. TSIKHMANOVICH, Y.K. KULIKOVICH

THE INFLUENCE OF THE STORAGE SOLUTIONS ON MORPHOLOGICAL CHARACTERISTICS OF HUMAN SAPHENOUS VEINS

EI Gomel State Medical University,
Republic of Belarus

Objective. To analyze and evaluate the effect of solutions for storage and storage times on the morphological characteristics of the human great saphenous vein.
Methods. 202 specimens of human saphenous veins obtained during phlebectomies or during CABG. The obtained samples immediately after harvesting from the patient were randomly placed into a sterile cardioplegic solution and a physiological solution with heparin and papaverine for further storage in a refrigerator at a temperature of +4C. Histological, morphological, and immunological studies of the obtained samples were carried out within a period from 1 day to 1 month. To study the effect of varicose transformation, the studied samples were divided into 2 groups: group 1 120 sections of the great saphenous vein with varicose transformation; group 2 - 82 veins without varicose transformation. Depending on the solution in which the samples were stored, the veins of the first group were subdivided into 2 subgroups: 40 veins were stored in 0.9% sodium chloride solution with the addition of papaverine and heparin (subgroup 1p) and 80 veins, which were stored in cardioplegic solution (subgroup 1c).
Results. The use of cold cardioplegic solution makes it possible to achieve complete decellularization of the saphenous vein within a period of 1 day to 1 week, while decomposition and homogenization of the conduit wall is observed within a period of two to three weeks, in the case of unchanged conduits, and within three weeks for veins with varicose veins deformation. Preservation of the collagen framework is observed in the period from the first days to three weeks of observation, which correlates with the preservation of the strength characteristics of venous conduits exposed to cold storage in cardioplegic solution. The loss of collagen fibers from their initial amount within 3 weeks for varicose veins is 8.6%, for veins without varicose transformation 13.5%.
Conclusion. The use of this method of storage of venous conduits makes it possible to achieve an adequate level of vascular decellularization already on the first day of storage, which helps to reduce the likelihood of subsequent rejection of the conduit and inducing of graft rejection reaction of the recipient, and the preservation of the collagen framework within a period up to three weeks makes it possible to use these conduits in vascular tissue engineering and for reconstructive vascular surgery.

Keywords: hypothermic storage, storage solutions, long-term storage of vein allografts, morphology of human saphenous vein, decellulization of veins
p. 186-197 of the original issue
References
  1. Albers M, Battistella VM, Romiti M, Rodrigues AA, Pereira CA. Meta-analysis of polytetrafluoroethylene bypass grafts to infrapopliteal arteries. J Vasc Surg. 2003 Jun;37(6):1263-69. doi: 10.1016/s0741-5214(02)75332-9
  2. Batt M, Feugier P, Camou F, Coffy A, Senneville E, Caillon J, Calvet B, Chidiac C, Laurent F, Revest M, Daures JP; Research Group for Vascular Graft Infection. A meta-analysis of outcomes after in situ reconstructions for aortic graft infection. Angiology. 2018 May;69(5):370-79. doi: 10.1177/0003319717710114
  3. Deutsch M, Meinhart J, Scheme J, Hubbell J, Zilla PP. Endothelial cell seeding: revisiting the issues. J Vasc Surg. 2000;31(6):1265-68.
  4. LHeureux N, Paquet S, Labbé R, Germain L, Auger FA. A completely biological tissue-engineered human blood vessel. FASEB J. 1998 Jan;12(1):47-56. doi: 10.1096/fasebj.12.1.47
  5. Kouzi-Koliakos K, Kanellaki-Kyparissi M, Marinov G, Knyazhev V, Tsalie E, Batzios C, Kovachev D. Prebypass histological and ultrastructural evaluation of the long saphenous vein as a predictor of early graft failure. Cardiovasc Pathol. 2006 Nov-Dec;15(6):336-46. doi: 10.1016/j.carpath.2006.07.005
  6. Buckley CJ, Abernathy S, Lee SD, Arko FR, Patterson DE, Manning LG. Suggested treatment protocol for improving patency of femoral-infrapopliteal cryopreserved saphenous vein allografts. J Vasc Surg. 2000 Oct;32(4):731-38. doi: 10.1067/mva.2000.110049
  7. Touma J, Cochennec F, Parisot J, Fialaire Legendre A, Becquemin JP, Desgranges P. In situ reconstruction in native and prosthetic aortic infections using cryopreserved arterial allografts. Eur J Vasc Endovasc Surg. 2014 Sep;48(3):292-99. doi: 10.1016/j.ejvs.2014.04.023
  8. Garot M, Delannoy PY, Meybeck A, Sarraz-Bournet B, dElia P, dEscrivan T, Devos P, Leroy O. Intra-abdominal aortic graft infection: prognostic factors associated with in-hospital mortality. BMC Infect Dis. 2014 Apr 22;14:215. doi: 10.1186/1471-2334-14-215
  9. Bisdas T, Wilhelmi M, Haverich A, Teebken OE. Cryopreserved arterial homografts vs silver-coated Dacron grafts for abdominal aortic infections with intraoperative evidence of microorganisms. J Vasc Surg. 2011 May;53(5):1274-81.e4. doi: 10.1016/j.jvs.2010.11.052
  10. Brockbank KG, Donovan TJ, Ruby ST, Carpenter JF, Hagen PO, Woodley MA. Functional analysis of cryopreserved veins. Preliminary report. J Vasc Surg. 1990 Jan;11(1):94-100; discussion 100-2. doi: 10.1016/0741-5214(90)90333-6
  11. Elmore JR, Gloviczki P, Brockbank KG, Miller VM. Cryopreservation affects endothelial and smooth muscle function of canine autogenous saphenous vein grafts. J Vasc Surg. 1991 May;13(5):584-92. doi: 10.1067/mva.1991.27527
  12. Faggioli GL, Gargiulo M, Giardino R, Pasquinelli G, Preda P, Fini M, Corbascio M, Stella A, DAddato M, Ricotta JJ. Long-term cryopreservation of autologous veins in rabbits. Cardiovasc Surg. 1994 Apr;2(2):259-65. doi: 10.1177/096721099400200224
  13. Bambang LS, Mazzucotelli JP, Moczar M, Beaujean F, Loisance D. Effects of cryopreservation on the proliferation and anticoagulant activity of human saphenous vein endothelial cells. J Thorac Cardiovas Surg. 1995 Oct 1;110(4):998-1004. doi: 10.1016/S0022-5223(05)80167-9
  14. Carpenter JP, Tomaszewski JE. Immunosuppression for human saphenous vein allograft bypass surgery: a prospective randomized trial. J Vasc Surg. 1997 Jul;26(1):32-42. doi: 10.1016/s0741-5214(97)70144-7
  15. Ochsner JL, Lawson JD, Eskind SJ, Mills NL, DeCamp PT. Homologous veins as an arterial substitute: long-term results. J Vasc Surg. 1984 Mar;1(2):306-13. doi: 10.1067/mva.1984.avs0010306
  16. Posner MP, Makhoul RG, Altman M, Kimball P, Cohen N, Sobel M, Dattilo J, Lee HM. Early results of infrageniculate arterial reconstruction using cryopreserved homograft saphenous conduit (CADVEIN) and combination low-dose systemic immunosuppression. J Am Coll Surg. 1996 Sep;183(3):208-16.
  17. Har-Shai Y, Sela E, Rubinstien I, Lindenbaum ES, Mitz V, Hirshowitz B. Computerized morphometric quantitation of elastin and collagen in SMAS and facial skin and the possible role of fat cells in SMAS viscoelastic properties. Plast Reconstr Surg. 1998 Dec;102(7):2466-70. doi: 10.1097/00006534-199812000-00033
  18. Hoch J, Jarrell BE, Schneider T, Williams SK. Endothelial cell interactions with native surfaces. Ann Vasc Surg. 1989 Apr;3(2):153-59. doi: 10.1016/S0890-5096(06)62009-8
Address for correspondence:
246046, Republic of Belarus, Gomel,
Meditsinskaya St. 4,
Gomel State Medical University,
Department of Surgery No 1,
tel./fax: . +375 232 49-19-54,
e-mail surgery_1@gsmu.by,
Tsikhmanovich Viktar E.
Information about the authors:
Lyzikov A.A., MD, Professor, Head of the Department of Surgery No 1 with the Course of Cardiovascular Surgery, EI Gomel State Medical University, Republic of Belarus.
https://orcid.org/0000-0003-0639-121X
Kaplan M.L., PhD, Associate Professor, Associate Professor of the Department of Surgery No 1 with the course of Cardiovascular Surgery, EI Gomel State Medical University, Republic of Belarus.
https://orcid.org/0000-0001-7782-3281
Zinovkin D.A., Assistant of the Department of Pathological Anatomy, EI Gomel State Medical University, Republic of Belarus.
https://orcid.org/0000-0002-3808-8832
Tsikhmanovich V.E., Assistant of the Department of Surgery No 1 with the course of Cardiovascular Surgery, EI Gomel State Medical University, Republic of Belarus.
https://orcid.org/0000-0002-3486-9113
Kulikovich Y.K., Assistant of the Department of Surgery No.1 with the course of Cardiovascular Surgery, EI Gomel State Medical University, Republic of Belarus.
https://orcid.org/0000-0002-1317-4662
Contacts | ©Vitebsk State Medical University, 2007