同种异体移植物在血管外科中的应用历史(文献回顾)

R. Kalinin, I. Suchkov, V. Karpov, A. Egorov, A. Pshennikov
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摘要

在这篇文章中,我们分析了在血管外科医生的实践中使用来自死后供体的同种异体移植物的问题。这反映了特殊临床情况下对供体材料的需求。并列出了同种移植物应用历史发展的主要阶段。本文从20世纪的历史角度阐述了国内外作者利用同种异体血管和主动脉重建介入治疗的经验。以美洲、欧洲、非洲、亚洲和俄罗斯为例,探讨了世界组织库发展的历史里程碑。对同种移植物使用的法律管制目前对俄罗斯联邦特别重要。使用同种移植物作为重建材料是在俄罗斯联邦的法律框架内。在21世纪,大量的现代研究都选择尸体同种移植物作为主干动脉重建的材料,无论是冷冻保存的还是湿储存的。严重缺血可能是使用尸体同形异构体的一个指示,但它们的植入显示出模糊的结果。永久性血液透析血管通路的感染也可以被认为是使用静脉同形物作为通路重建材料的指征。结论:供体材料目前在许多中心的血管外科实践中得到了积极的应用,临床适应症多样化的希望越来越大,未来同种异体移植也有望在俄罗斯临床指南中占有一席之地。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
History of Use of Homografts in Vascular Surgery (Literature Review)
INTRODUCTION: In the article, problems of use of allografts from a posthumous donor in the practice of a vascular surgeon are analyzed. The need for donor material in special clinical situations is reflected. The main stages of the historical development of the use of homografts are listed. The experience of foreign and domestic authors in reconstructive interventions on the main vessels and aorta using homografts is demonstrated in the historical perspective of the XXth century. Historical milestones in the development of tissue banks in the world are considered on an example of America, Europe, Africa, Asia and Russia. The legal regulation of use of homografts is at present especially relevant for the Russian Federation. The use of homografts as a material for reconstruction is stated to be within the legal framework of the Russian Federation. A large number of modern studies in the 21st century are carried out with choice of cadaveric homografts, both cryopreserved and of wet storage, as the material for reconstruction of the main arteries. Critical ischemia is a probable indication for the use of cadaveric homographs, but their implantation shows ambiguous results. Infection of a permanent vascular access for hemodialysis can also be considered as an indication for the use of a venous homograph as the material for access reconstruction. CONCLUSION: The donor material is currently being actively used in the practice of vascular surgery in many centers, and the hope for the diversification of clinical indications is growing, as well as for homografts finding the place in Russian clinical guidelines in future.
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