Outcomes of Cryopreserved Allografts for Aortoiliac Reconstruction in Infected and Contaminated Fields
Recommended Citation
Chamseddine H, Kabbani L, Kavousi Y, Nypaver TJ, Weaver MR, Onofrey KT, Peshkepija A, Lee A, Shepard AD. Outcomes of Cryopreserved Allografts for Aortoiliac Reconstruction in Infected and Contaminated Fields. J Am Coll Surg 2024; 239(5):S577.
Document Type
Conference Proceeding
Publication Date
11-1-2024
Publication Title
J Am Coll Surg
Abstract
Introduction: Limited literature exists on Cryopreserved Allografts (CPA) complication rates, specifically in terms of reinfection, aneurysmal degeneration, and rupture. This study aims to assess outcomes of CPA for aortoiliac reconstruction in the setting of infection/contamination. Methods: A single-center retrospective review of patients who received CPA for aortoiliac reconstruction for infection/contamination between 2000-2023 was performed. Primary outcomes included CPA reinfection, rupture, aneurysmal degeneration, stenosis, and thrombosis. Results: Forty-nine patients (34 men, 15 women) with mean age of 65 years met inclusion criteria. Indications for CPA included 16 native artery infections and 33 graft/stent infections. Positive intraoperative cultures were found in 76% (37/49) of patients. Median follow up time was 25 months. 30-day, 1-year and 5-year survival rates were 90%, 72% and 63% respectively. Early (30-day) CPA-related complications were observed in 6% (n = 3) of patients and included anastomotic dehiscence (1) and graft thrombosis (2). One-year CPA-related complications affected 17% (n = 7) of patients and included graft aneurysmal degeneration and rupture (2), anastomotic dehiscence (2), and graft thrombosis (3) (Figure 1). All graft-related complications occurred within the first post-operative year. Complications were not associated with infection type (native artery vs graft/stent) or type of organism cultured. Freedom from graft-related reintervention at 5-years was 85%. Re-intervention at 5-years included procedures for rupture (2), anastomotic dehiscence (1), occlusion (2), and uretero-graft limb fistula (1). Conclusion: Cryopreserved allografts are an acceptable conduit for aortoiliac reconstruction in infected or contaminated fields, with all complications happening within 12 months of implantation. Aggressive early surveillance is mandatory for optimal outcomes. (Figure Presented).
Volume
239
Issue
5
First Page
S577
