Complications and grafts in septic vascular surgery - Analysis of the thrombogenicity properties of cryopreserved allografts and the determination of the healthy vascular microbiota
Hidi László
Clinical Medicine
Dr. Reusz György
SE Városmajori Klinikák Tanterme
2024-09-17 13:00:00
ógia/atherosclerosis
Dr. Prohászka Zoltán
Dr. Sótonyi Péter
Dr. Huszty Gergely Dénes
Dr. Takács Tibor
Dr. Sándor József
Dr. Ruppert Mihály
Dr. Galambos Barnabás
Even with modern infection control strategies, 3.5-32% of vascular surgical procedures are still
associated with infection in the surgical site. The main risk of the inflammatory process is the
development of life- or limb-threatening complications. There is a long-standing, unfulfilled
demand for a surgeon-friendly, infection-resistant, biocompatible, durable, off-the-shelf graft
material to prevent or treat these conditions. Although allografts come close to this, vascular
allograft transplants are still associated with many complications. The reasons for these are
likely found in the processes of graft production on the one hand and in the circumstances of
the transplantation on the other.
In our work, we analysed the CP protocol of the Cardiovascular Biobank of Semmelweis
University, with particular emphasis on the direct and storage time-dependent effects of CP on
the thrombogenicity of arterial allografts. In addition, we analysed the human vascular
microbiota by examining arterial allografts as healthy vascular tissue. Our results on
thrombogenicity showed that arterial allografts preserved haemostatic properties similar to
fresh native arterial walls during CP with storage for six months. In addition, fibrin deposition
and platelet adhesion on cryopreserved arterial allografts decreased over time, demonstrating a
reduction in their thrombogenic potential. The only transient prothrombotic change was
observed in the media layer, where platelet deposition exceeded that of fresh native grafts
within the first twelve weeks after CP. In addition, in our study, we successfully developed a
method for identifying the human vascular microbiota using arterial allografts, which allowed
us to determine the bacterial composition of vascular samples from healthy individuals.
Furthermore, we demonstrated the uniqueness of the healthy vascular microbiota by comparing
our results with physiological microbiota found elsewhere in the body.
Our thrombogenicity results demonstrate the effect of frozen storage time on allografts. This
prompts us to investigate longer storage times further to optimise the production of
cryopreserved allografts and the potential need for drug therapy. Besides, our microbiological
results, in addition to demonstrating the existence of a healthy vascular microbiota, could form
the basis for future research into the direct role of the microbiota in vascular wall disorders and
the success of allograft transplantation.
