4. 2. 2021

Vascular transplantation in VFN

Doctors from VFN have already performed one hundred vascular transplants. These were mainly patients with threatened limb amputation or patients with infection of an artificial vascular prosthesis.

A 60-year-old woman with critical lower limb ischemia and impending amputation underwent a 100-fold vascular transplant at the General Hospital. On the contrary, the very first performance of this type was performed by doctors in 2010, when, based on the decision of the Ministry of Health of the Czech Republic, the II. surgical clinic of cardiovascular surgery VFN and the 1st Medical Faculty of Charles University established the Vascular Transplant Center. Thanks to the status of a vascular transplant center, doctors can place their patients on a waiting list and, in cooperation with IKEM, can participate in a multi-organ collection, during which they collect blood vessels for patients.

Initially, doctors used fresh grafts. They were collected in multiorgan specimens and had to sew vessels from suitable donors to patients within 48 hours. The waiting period was two to three weeks and about a third of the patients did not receive a suitable graft. Therefore, doctors have launched a program of so-called cryopreserved or frozen grafts, which now cover 60 percent of all vascular transplants in the VFN. "We will take the vessels and take them to the University Hospital Hradec Králové, where they will freeze them in Tkáňová banka. They can then be stored at -190 ° C for up to five years. The main advantage of cryo is immediate availability. The patient arrives one day and if the graft is urgently needed and is available in the tissue bank, we will find it the next day, "explained the procedure of the coordinator of the vascular transplant center VFN and the head of the Working Group for Vascular Replacements and Allotransplantation ČSKVCH MUDr. Miroslav Spacek, PhD.

Surgery is suitable, for example, in patients with atherosclerosis of the limb arteries who do not have a suitable graft and the disease has progressed to the stage of limb defects. Transplantation is often the only solution to prevent limb amputation. Another group of patients are those who suffer from infection of the implanted vascular prosthesis and there is no other suitable solution for them.

During the procedure, doctors replace the part of the vessel that is either closed or affected by the infection. They remove the infected vascular prosthesis and replace it with an infection-resistant material

In the last 10 years, doctors throughout the Czech Republic have performed about 500 vascular transplants, a fifth of which took place at the General Hospital.

 

Preparation of vascular allograft after thawing, before suturing to the patient.

 

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