Cold-stored Venous Allografts in the Treatment of Critical Limb Ischaemia

ObjectivesTo assess the outcome of cold-stored venous allografts in critically ischemic limbs in patients with no ipsilateral autogenous greater saphenous vein.DesignA non-randomised, retrospective, single-center study.MethodsFrom September 2000 to June 2006, 46 cold-stored venous allografts obtained during multiorgan harvest were implanted into 44 critically ischaemic limbs of 43 patients. The indication for reconstructions was rest pain (24%) or tissue lost (76%). Sixty-seven percent of procedures were performed as secondary reconstructions, and 61% of veins were anastomosed to tibial or pedal arteries. Thirty-seven percent of patients received prednisone, and 46% tacrolimus as postoperative immunosuppressive therapy. Mean patient follow-up period was 13.3 months (range 1 week to 60 months).ResultsThe secondary patency rate for the cohort was 83±5.6% at 1 month, 64±8.2% at 6 months, 57±10.0% at 12 months and 46±10.7% at 24 months. Limb salvage rate was 96±3.1% at 1 month, 78±6.9% at 6 months, 71±8.1% at 12 months and 50±11.8% at 24 months.ConclusionCold-stored venous allografts are an alternative conduit for limb salvage procedures when ipsilateral autogenous vein is unavailable