Bovine carotid artery biologic graft outperforms expanded polytetrafluoroethylene for hemodialysis access

Arhuidese, Isibor; Reifsnyder, Thomas; Islam, Tasnim; Karim, Omar; Nejim, Besma; Obeid, Tammam; Qazi, Umair; Malas, Mahmoud B.

doi:10.1016/j.jvs.2016.10.080

Cited by 36 publications

(51 citation statements)

References 28 publications

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“…[6][7][8] Candidates awaiting kidney transplant are taught to avoid sensitizing events, if at all possible, for fear of limiting the donor pool to which they are compatible. We also acknowledge the smaller sample size with limited power to detect small differences between groups.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with end-stage renal disease, AVFs are preferable to AVGs due to their lower complication rate and overall longevity; this consensus fueled the Fistula First Breakthrough Initiative (FFBI) in 2006, 1 which prioritized native AVFs for all patients where possible. [6][7][8] Arteriovenous graft implants may include biologic (bovine carotid artery [BCA]) and synthetic (expanded polytetrafluoroethylene, ePTFE) material. In these patients, AVGs are appropriate alternatives and still allow patients to avoid a central venous catheter for dialysis.…”

Section: Introductionmentioning

confidence: 99%

“…2 Still, in many patients, a fistula may not be feasible due to insufficient diameter vessels and other comorbidities. [6][7][8] However, concern regarding immunologic human leukocyte antigen (HLA) sensitization may limit the use of BCA in the kidney transplant candidate. One unintended result of the FFBI was the high prevalence of immature native AVFs and a resulting high number of patients continuing to dialyze with a tunneled catheter.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between bovine carotid artery grafts for hemodialysis access and human leukocyte antigen sensitization

Dyer‐Kindy

Gladden

Gralla

et al. 2019

Hemodialysis International

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Introduction: Bovine carotid artery (BCA) Artegraft is a biologic graft that can be utilized as a conduit for permanent hemodialysis access and has been shown to outperform polytetrafluoroethylene grafts. However, concern regarding immunologic sensitization may limit the use of BCA in the transplant candidate. Panel reactive antibody (PRA) is an immunological test utilized in transplant recipient selection whereas increases in PRA limit access to transplantation. The purpose of our study was to determine whether BCA graft placement was adversely associated with increases in PRA.Methods: Of patients listed for kidney transplant at our institution, we identified 10 patients who underwent BCA placement for hemodialysis access and a matched cohort of 10 patients who underwent native arteriovenous fistula (AVF) creation between 2014 and 2017. The PRA value nearest to the surgery date was compared to postsurgery PRA value for the BCA and AVF patients using a paired t test. Presurgery PRAs were also compared to the maximum PRA at 0 to 6, 6 to 12, 12 to 18, and 18 to 24 months postsurgery.Findings: Prior to the dialysis access operation, the mean PRA was 14.1% AE 23.5% vs. 17.1% AE 29.0% (P = 0.76) and the median postsurgery follow-up time was 16 and 15 months for BCA and AVF cohorts, respectively. There were no statistically significant differences between presurgery and postsurgery PRA for BCA and AVF patients, regardless of time interval postsurgery. The difference in presurgery/postsurgery PRA change between cohorts was not statistically significant for PRAs closest to surgery (0.2% AE 40.6% vs. 1.0% AE 2.8%, P = 0.95, at a median 4 and 3 months postsurgery, respectively) or when using the maximum in any postsurgery interval. Prior to their dialysis access surgery, there were 16 sensitizing events in 5 patients in the BCA group compared to 10 events in 5 patients in the AVF group (P = 0.20). Only 1 of the 10 patients in the BCA group had a clinically relevant and sustained increase in PRA following their dialysis access operation vs. no patients in the AVF group (P > 0.99). However, this patient had a known sensitizing event (blood transfusion) between the BCA surgery and the postoperative PRA. Three of 10 patients in the BCA cohort vs. 5 of 10 patients in the AVF cohort went on to have successful kidney transplants (P = 0.65).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between bovine carotid artery grafts for hemodialysis access and human leukocyte antigen sensitization

Dyer‐Kindy

Gladden

Gralla

et al. 2019

Hemodialysis International

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“…In a cohort study of patients who received arteriovenous grafts, primary and primary assisted patencies were similar between bovine carotid artery (BCA) biologic graft and expanded polytetrafluoroethylene (ePTFE). However, secondary patency was higher for BCA, indicating better durability for the biologic graft than for ePTFE grafts . In our center, the preprocessed artery was first used as vascular access for arteriovenous internal fistula, and from this experience, we decided to use it to save the kidney graft for bridging after attempt the failure of simply repair and arterial patching.…”

Section: Discussionmentioning

confidence: 99%

“…However, secondary patency was higher for BCA, indicating better durability for the biologic graft than for ePTFE grafts. 20 In our center, the preprocessed artery was first used as vascular access for arteriovenous internal fistula, and from this experience, we decided to use it to save the kidney graft for bridging after attempt the failure of simply repair and arterial patching.…”

Section: Discussionmentioning

confidence: 99%

Successful repair of kidney graft artery rupture secondary to infection using a preprocessed homologous “Y”‐shaped iliac artery

Liu

Wang

et al. 2019

Clinical Transplantation

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ObjectivesThis retrospective study aims to describe novel ways of repair kidney allograft artery rupture secondary to infection using a preprocessed homologous “Y”‐shaped iliac artery.MethodsFive patients' whose course was complicated by graft arterial rupture were included in the rupture group, and patients who received the kidney from the same donor were included in the control group. In the rupture group, the iliac artery used for revascularization was harvested from a DCD donor, pre‐treated with absolute diethyl ether, followed by absolute alcohol, and then preserved in 75% alcohol. A biopsy of the arterial graft was obtained and stained using hematoxylin and eosin (H&E). Once a patient was diagnosed with kidney allograft arterial rupture by ultrasound, emergency surgery was conducted and the preprocessed “Y”‐shaped iliac artery was used for bridging.ResultsFive patents were included in the rupture group. The “Y”‐shaped iliac artery grafts were successfully preprocessed, H&E staining and electron microscope observation revealed few visible nuclei, with karyorrhexis and karyolysis. There were no significant differences in the long‐term graft survival between two groups.ConclusionsIn conclusion, using preprocessed homologous “Y”‐shaped iliac artery provides a useful method to bridge the vascular defects from kidney graft artery rupture secondary to infection in renal allograft recipients.

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Tissue‐Engineered Vascular Grafts: Emerging Trends and Technologies

Gupta

Mandal

2021

Adv Funct Materials

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Vascular tissue engineering has made prodigious progress in recent years by converging multidisciplinary approaches. Latest technological advancements foster the development of next‐generation tissue‐engineered vascular grafts (TEVGs) for treating various vasculopathies. While traditional therapeutic methods rely on bypassing the severely damaged vessels with synthetic counterparts with no growth potential, contemporary perspectives focus on biodegradable conduits bestowing an inherent remodeling capability. This review highlights emerging innovative trends and technologies adopted to pragmatically fulfill current scientific needs while improving overall TEVG performance in pre‐clinical and clinical settings. A comprehensive overview of various milestones achieved in the past few decades is first summarized, followed by an appraisal of the significant hurdles for clinical translation. The latest techniques to rationally address critical challenges, viz., intimal hyperplasia, thrombosis, constructive graft remodeling, and adequate neo‐tissue formation are discussed. Finally, an update on ongoing clinical trials is provided and future perspectives required to persuade TEVGs to become a clinical reality are delineated.

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Bovine carotid artery biologic graft outperforms expanded polytetrafluoroethylene for hemodialysis access

Cited by 36 publications

References 28 publications

Relationship between bovine carotid artery grafts for hemodialysis access and human leukocyte antigen sensitization

Relationship between bovine carotid artery grafts for hemodialysis access and human leukocyte antigen sensitization

Successful repair of kidney graft artery rupture secondary to infection using a preprocessed homologous “Y”‐shaped iliac artery

Tissue‐Engineered Vascular Grafts: Emerging Trends and Technologies

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