Features of the morphohistological picture of homografts in different periods of conservation

• Kalinin R.E.
• Igor А. Suchkov
• Karpov V.V.
• Klimentova E.A.
• Shvalb A.P.
• Guzairov D.V.
• Egorov A.A.

Abstract

Aim. Evaluate the histological dynamics of cadaveric homografts during preservation in RPMI 1640 solution over time.

Material and methods. Morphological examination of cadaveric homografts of the common femoral vein and superficial femoral artery was performed. 72 samples from a postmortem donor were studied. Histological examination was carried out on days 7, 14, 21, 28, 35, 42 days after taking two arterial and venous preparations of homografts, respectively. 6 comparison groups of arterial and venous homografts were obtained. 36 arterial and 36 venous samples were studied. The dynamics of the thickness of the intimo-muscular complex, the thickness of the muscular membrane and the thickness of the internal elastic membrane in the arterial homograft and the wall thickness without adventitia in the venous homograft were evaluated.

Results. There is a decrease in the thickness of the intimo-muscular complex (р=0.043) by 21% at the end of day 21 in comparison with the values of day 7, but there was an increase in the thickness of this indicator by 51% (р=0.001) on day 28 in comparison with the values of day 21. The thickness of the muscle layer on day 2 decreased by 19.5% (statistically non-significant) in comparison with the indicators of day 7, but the thickness of the muscle layer by day 28 increased (р=0.01) by 49.8% in comparison with the values of this indicator on day 21 due to the rarefaction of the muscle portion of the wall, swelling of myocytes, changes in the nuclei in the form of fragmentation and lysis. The thickness of the internal elastic membrane decreased by day 21 (р=0.035) by 12.3% in comparison with the values of day 7. By day 42, there was a tendency to increase its thickness. A decrease in the wall thickness of the venous homograft without adventitia (р=0.014) was revealed at the end of day 42 by 23.4% in comparison with the value of this indicator on day 7, and a decrease in the thickness of the venous graft was also noted at the end of day 42.

Conclusion. In our opinion, the most "sensitive" marker of tissue necrosis in the morphohistological method of examining the graft wall is the study of the dynamics of its thickness at various conservation periods. Since the swelling of cells and fibers will lead to an increase in wall thickness, and then, to subsequent total necrosis. By the end of day 28 of preservation, a statistically significant increase in the artery wall in comparison with the indicators of day 21, areas of muscle tissue discharge were revealed. There was a tendency to increase the thickness of the artery wall by day 42. A statistically significant decrease in wall thickness was revealed in the venous homograft by the end of the study. Based on these data, it is rational to talk about a longer storage possibility for the purpose of using a venous cadaveric conduit. The preservation period in RPMI 1640 solution up to 21 days is the optimal period for the use of arterial homografts.  Venous homografts can be used for up to 42 days.

Keywords:homograft; allograft; morphohistological picture; RPMI 1640 solution

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