История применения гомографтов в сосудистой хирургии (литературный обзор)

Abstract

INTRODUCTION: In the article, problems of use of allografts from a posthumous donor in the practice of a vascular surgeon are analyzed. The need for donor material in special clinical situations is reflected. The main stages of the historical development of the use of homografts are listed. The experience of foreign and domestic authors in reconstructive interventions on the main vessels and aorta using homografts is demonstrated in the historical perspective of the XXth century. Historical milestones in the development of tissue banks in the world are considered on an example of America, Europe, Africa, Asia and Russia. The legal regulation of use of homografts is at present especially relevant for the Russian Federation. The use of homografts as a material for reconstruction is stated to be within the legal framework of the Russian Federation. A large number of modern studies in the 21st century are carried out with choice of cadaveric homografts, both cryopreserved and of wet storage, as the material for reconstruction of the main arteries. Critical ischemia is a probable indication for the use of cadaveric homographs, but their implantation shows ambiguous results. Infection of a permanent vascular access for hemodialysis can also be considered as an indication for the use of a venous homograph as the material for access reconstruction. CONCLUSION: The donor material is currently being actively used in the practice of vascular surgery in many centers, and the hope for the diversification of clinical indications is growing, as well as for homografts finding the place in Russian clinical guidelines in future.