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Neointimal hyperplasia in allogeneic and autologous venous grafts is not different in nature

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Neointimal hyperplasia, transplant rejection and thus immunogenicity of allografts are possible reasons for poorer patency rates in cryopreserved venous allografts for peripheral bypass surgery in comparison with autologous venous grafts. To expand the limited knowledge from human allografts, we histologically investigated allogeneic and autologous venous grafts in arterial location. Specimens of allogeneic and autologous venous graft stenosis, harvested 6 months after bypass implantation, were immunohistochemically characterized. Examination of the lesions showed a uniform morphological pattern. A continuous endothelial layer, tissue fibrosis and a thickened neointima with monocytes and dedifferentiated vascular smooth muscle cells were seen in both conduits with very low cell turnover and the absence of acute and chronic inflammation. Neoangiogenesis with CD34-positive endothelium was abundant in the vessel media. The morphological patterns of allogeneic and autologous neointima formation are similar. Consequently, neointimal hyperplasia in venous grafts may reflect a uniform physiological host response of non-immunological factors with the reasons for poorer clinical outcome of cryopreserved allografts yet to be elucidated.

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Peripheral arterial disease




Vascular smooth muscle cell


Endothelial nitric oxide synthase


Extracellular matrix


Vasa vasorum


Vascular endothelial growth factor


Digital subtraction angiography




Endothelial cell


Cluster of differentiation


Platelet/endothelial cell adhesion molecule


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We thank the IZKF Wuerzburg for funding of the conducted study. We thank to B. Treffny, E. Kleinschrodt and C. Pregitzer for skillful technical assistance. We also thank C. Buehler and C. Tiurbe for their help with tissue sample acquisition and S. Duell for help with patient care. A.B. and U.L. had overall responsibility for the manuscript. E.H. and N.W. helped with data interpretation. R.K. and R.K. helped with data collection, and S.E. beholds final manuscript approval.

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Correspondence to Busch Albert.

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Supplementary Table 1 Patients’ characteristics and outcome after open bypass repair show heterogeneous baseline variables (DOCX 90 kb)

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Albert, B., Elena, H., Nicole, W. et al. Neointimal hyperplasia in allogeneic and autologous venous grafts is not different in nature. Histochem Cell Biol 144, 59–66 (2015).

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