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

Abstract

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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Abbreviations

PAOD:

Peripheral arterial disease

PTFE:

Polytetrafluoroethylene

VSMC:

Vascular smooth muscle cell

eNOS:

Endothelial nitric oxide synthase

ECM:

Extracellular matrix

VV:

Vasa vasorum

VEGF:

Vascular endothelial growth factor

DSA:

Digital subtraction angiography

DAPI:

4,6-Diamidin-2-phenylindol

EC:

Endothelial cell

CD:

Cluster of differentiation

PECAM1:

Platelet/endothelial cell adhesion molecule

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Acknowledgments

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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All authors declare no conflict of interest.

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Correspondence to Busch Albert.

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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). https://doi.org/10.1007/s00418-015-1317-3

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Keywords

  • Cryopreserved vein
  • Bypass stenosis
  • Neointimal hyperplasia
  • Angiogenesis
  • Chronic limb ischemia