Cryopreserved arterial allograft reconstruction after excision of XXXX .

@entity1 @entity242 @entity5 @entity1149 @entity2 @entity3386
BACKGROUND: The purpose of this study was to evaluate the long-term clinical and immunologic outcome of cryopreserved arterial allograft ( @entity3386 ) revascularization of intrathoracic vessels invaded by @entity5 . METHODS: Since January 2002, consecutive @entity1 whose intrathoracic vessels were invaded by @entity5 were operated on and revascularizion made using human lymphocyte antigen (HLA)- and ABO-mismatched CAAs. Immunologic studies were performed preoperatively, and 1, 3, 6, 12, and 24 months postoperatively. Postoperative oral anticoagulation therapy was not given. RESULTS: Twenty-six @entity1 aged 53.1 +/- 15 years with @entity1149 (n = 10), invasive @entity5 (n = 7), pulmonary @entity242 (n = 3), laryngeal (n = 2), or other @entity2 (n = 4) underwent operation. Cardiopulmonary bypass was used in 10 cases (38%), and all resections were pathologically complete. Revascularization was either for venous (n = 12) or arterial (n = 14) vessels, and a total of 30 allografts revascularized the superior vena cava (n = 6), pulmonary artery (n = 7), innominate vein (n = 3) or artery (n = 2), ascendent (n = 4) or descending (n = 1) aorta, and subclavian vein (n = 3) or artery (n = 4). Hospital morbidity and mortality were 50% (n = 13) and 3.8% (n = 1), respectively, all @entity3386 unrelated. With a median follow-up of 18 months (range, 3 to 60+), 5-year survival and allograft patency were 84% and 95%, respectively. Preoperative anti-HLA antibodies were detected in 2 @entity1 (7.7%) and a postoperative anti-HLA antibody response, clinically irrelevant, in 1 of 24 @entity1 (4%). CONCLUSIONS: Revascularization of intrathoracic venous and arterial vessels in @entity1 with @entity5 using HLA- and ABO-mismatched @entity3386 is technically feasible and clinically attractive because of no infection risk and postoperative anticoagulation, and excellent long-term survival, patency, and nonimmunogeneicity.
