Cases of massive purulent infection of vascular prosthesis are demonstrated in
this study. Infected prosthesis was substituted by arterial homograft, harvested
during multi-organ procurement, and stored by the cold ischaemia method. In
the follow-up period, the patients were divided into two groups, those treated
with immunosuppression (n = 16) and those treated without immunosuppressive
drugs (n = 13). The patients underwent resurgery, during which a fragment
of arterial wall was taken for electron microscopic examination.
In the group with immunosuppression, the presence of the following structures
was observed: endothelial cells, the intima, with a great number of elastic and
collagen fibrils with fibrinogen inclusions, and active phagocyting myoblasts and
myofibroblasts. In the group without immunosuppression electron microscopic
examination showed the total destruction of the wall of the ruptured arterial
homograft - absence of endothelium and sparse, damaged fibroblasts of the
media or their degraded fragments, making a picture of cellular death.
Morphological analysis of the arterial wall and the clinical state of the patient
suggest the necessity of immunosuppressive treatment after fresh arterial homograft
transplantation
