Abstract
Vascular allotransplantations are performed worldwide in selected patients suffering from vascular prosthesis infection or critical limb ischemia. Either fresh or cryopreserved vascular allograft may be used. In various points, we address several aspects (allograft procurement, cryopreservation and transplantation technique) of the program of vascular allotransplantations in the Czech Republic. Vascular grafts retrieval has been done within multiorgan harvests using no-touch technique. Very short time of cold ischemia is achieved due to close cooperation with Tissue Establishment where the following processing of cryopreservation is performed. Meeting all necessary quality criteria is a prerequisity for releasing grafts for clinical application. Standardized thawing protocol and surgical handling aims to minimize microfractures before implantation. Based on experimental and clinical work, the first validation of cryopreserved arterial and venous grafts for clinical use was performed between 2011 and 2013 in the Czech Republic. The developement of storage of vascular tissue in banks was stimulated in 2000-2010 by the issue of EU directives and national harmonized norms, aimed at assurance of high quality and safety of cells and tissues used for transplantations in humans. There are several crucial moments affecting final quality, including graft retrieval within a multiorgan harvest, short ischemic time, cryopreservation and thawing technique used. The recommended surgical handling during implantation may also affect results and graft-related complications.
Highlights
Vascular allotransplantations are performed worldwide in selected patients suffering from vascular prosthesis infection or critical limb ischemia
We address several aspects of the program of vascular allotransplantations in the Czech Republic
The developement of storage of vascular tissue in banks was stimulated in 2000–2010 by the issue of EU directives and national harmonized norms, aimed at assurance of high quality and safety of cells and tissues used for transplantations in humans
Summary
Vascular allotransplantations are performed worldwide in selected patients suffering from vascular prosthesis infection or critical limb ischemia. All the aspects and the up-to-date state of the transplantation program of cryopreserved vascular allografts in the Czech Republic introduced in 2011 are presented In this country, there is a network of licensed surgical facilities performing vascular graft retrieval as a part of multiorgan recovery. (Human Cell and Tissue Act) and Decree of the Ministry of Health No 422/2008 Coll.[1,2] Cryopreservation of collected grafts, subsequent storage at liquid nitrogen temperatures and quality control until the release of grafts for clinical application are the main duties of the tissue bank This service is, accessible only for transplant centers involved in the program.
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