Vascular homografts: Clinical results

The authors review the results of clinical experiences regarding arterial and venous homografts. For the treatment of mycotic aneurysms and infected prostheses, in situ repair with vascular homografts represents a valuable alternative to conventional surgical treatments. In fact the large caliber arterial homografts allow safe in situ reconstruction, decrease early and midterm mortality and reinfection rates; the best results are achieved in case of infected grafts, whereas the prognosis of vasculo-enteric fistula remains very poor. The small caliber arterial homografts also have demonstrated satisfactory results in term of patency although further experiences with longer follow-up are required. Vein homograft constitutes an alternative by-pass conduit for limb revascularisation in patient who lack adequate autogenous vein: although limb salvage rate is satisfactory long term patency rate is poor when compared with autogenous veins. Improvement of preservation methodics, pharmacological control of rejection and tissue engineering represent thefiture perspectives in this field.