Impact of valve fenestrations and structural changes in homografts on the long-term outcome in the recipient
Axelsson, Ida LU ; Malm, Torsten LU and Nilsson, Johan LU
(2021)
In Cell and Tissue Banking
22(3).
p.399-408
- Abstract
Homografts have long been used for right ventricular outflow tract (RVOT) reconstruction. Tissue banks struggle to meet the clinical demand of tissue, with insufficient donor availability and strict recommendations on tissue quality with high proportions of discards. This study analyzes the long-term outcome of patients receiving a homograft with small fenestrations of the cusps or other structural changes, to evaluate if minor impairment of the homograft affects the durability. Homograft characteristics and patient outcome were described. Follow-up was maximum 24 years. Structural changes of the homografts were analyzed in relation to patient outcome, using univariable and multivariable Cox proportional hazard regression. Between 1995... (More)
Homografts have long been used for right ventricular outflow tract (RVOT) reconstruction. Tissue banks struggle to meet the clinical demand of tissue, with insufficient donor availability and strict recommendations on tissue quality with high proportions of discards. This study analyzes the long-term outcome of patients receiving a homograft with small fenestrations of the cusps or other structural changes, to evaluate if minor impairment of the homograft affects the durability. Homograft characteristics and patient outcome were described. Follow-up was maximum 24 years. Structural changes of the homografts were analyzed in relation to patient outcome, using univariable and multivariable Cox proportional hazard regression. Between 1995 and 2018, 468 patients received 535 homografts in the RVOT in Lund. Median recipient age was 13 years. There were 137 (26.9%) reinterventions. Freedom from reintervention was 75.8% (95% CI 71.3–79.7%) at 10 years and 57.4% (95% CI 50.0–64.0%) at 20 years. Small fenestrations of the cusps, fibrosis of the cusps and minor atheromatosis of the vessel did not show any statistically significant impact on long-term outcome, hazard ratio = 0.46 (95% CI 0.11–1.87, p = 0.276) and hazard ratio = 0.80 (95% CI 0.25–2.56, p = 0.704). Minor structural changes of the homografts seem to be acceptable without affecting the long-term durability.
(Less)
- author
- Axelsson, Ida
LU
; Malm, Torsten
LU
and Nilsson, Johan
LU
- organization
- publishing date
- 2021-02-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Homograft, Long-term outcome, Right ventricular outflow tract, Tissue bank, Valve fenestrations
- in
- Cell and Tissue Banking
- volume
- 22
- issue
- 3
- pages
- 399 - 408
- publisher
- Springer
- external identifiers
-
- pmid:33576920
- scopus:85100953593
- ISSN
- 1389-9333
- DOI
- 10.1007/s10561-020-09886-5
- language
- English
- LU publication?
- yes
- id
- d723eda2-9e90-4c7c-bba5-484c2b43b553
- date added to LUP
- 2021-03-02 12:38:18
- date last changed
- 2024-06-13 07:52:54
@article{d723eda2-9e90-4c7c-bba5-484c2b43b553,
abstract = {{<p>Homografts have long been used for right ventricular outflow tract (RVOT) reconstruction. Tissue banks struggle to meet the clinical demand of tissue, with insufficient donor availability and strict recommendations on tissue quality with high proportions of discards. This study analyzes the long-term outcome of patients receiving a homograft with small fenestrations of the cusps or other structural changes, to evaluate if minor impairment of the homograft affects the durability. Homograft characteristics and patient outcome were described. Follow-up was maximum 24 years. Structural changes of the homografts were analyzed in relation to patient outcome, using univariable and multivariable Cox proportional hazard regression. Between 1995 and 2018, 468 patients received 535 homografts in the RVOT in Lund. Median recipient age was 13 years. There were 137 (26.9%) reinterventions. Freedom from reintervention was 75.8% (95% CI 71.3–79.7%) at 10 years and 57.4% (95% CI 50.0–64.0%) at 20 years. Small fenestrations of the cusps, fibrosis of the cusps and minor atheromatosis of the vessel did not show any statistically significant impact on long-term outcome, hazard ratio = 0.46 (95% CI 0.11–1.87, p = 0.276) and hazard ratio = 0.80 (95% CI 0.25–2.56, p = 0.704). Minor structural changes of the homografts seem to be acceptable without affecting the long-term durability.</p>}},
author = {{Axelsson, Ida and Malm, Torsten and Nilsson, Johan}},
issn = {{1389-9333}},
keywords = {{Homograft; Long-term outcome; Right ventricular outflow tract; Tissue bank; Valve fenestrations}},
language = {{eng}},
month = {{02}},
number = {{3}},
pages = {{399--408}},
publisher = {{Springer}},
series = {{Cell and Tissue Banking}},
title = {{Impact of valve fenestrations and structural changes in homografts on the long-term outcome in the recipient}},
url = {{http://dx.doi.org/10.1007/s10561-020-09886-5}},
doi = {{10.1007/s10561-020-09886-5}},
volume = {{22}},
year = {{2021}},
}