BACKGROUND: Vascular allotransplantations are performed worldwide in selected patients suffering from vascular prosthesis infection or critical limb ischemia. Either fresh or cryopreserved vascular allograft may be used. OBJECTIVES: In various points, we address several aspects (allograft procurement, cryopreservation and transplantation technique) of the program of vascular allotransplantations in the Czech Republic. MATERIAL AND METHODS: Vascular grafts retrieval has been done within multiorgan harvests using no-touch technique. Very short time of cold ischemia is achieved due to close cooperation with Tissue Establishment where the following processing of cryopreservation is performed. Meeting all necessary quality criteria is a prerequisity for releasing grafts for clinical application. Standardized thawing protocol and surgical handling aims to minimize microfractures before implantation. RESULTS: Based on experimental and clinical work, the first validation of cryopreserved arterial and venous grafts for clinical use was performed between 2011 and 2013 in the Czech Republic. The developement of storage of vascular tissue in banks was stimulated in 2000-2010 by the issue of EU directives and national harmonized norms, aimed at assurance of high quality and safety of cells and tissues used for transplantations in humans. CONCLUSIONS: There are several crucial moments affecting final quality, including graft retrieval within a multiorgan harvest, short ischemic time, cryopreservation and thawing technique used. The recommended surgical handling during implantation may also affect results and graft-related complications.

2nd Department of Surgery Department of Cardiovascular Surgery 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Czech Republic

2nd Department of Surgery St Anne's University Hospital Faculty of Medicine Masaryk University Brno Czech Republic

Center of Cardiovascular Surgery and Transplantations Brno Czech Republic

Department of Surgery University Hospital and Faculty of Medicine Hradec Kralove Charles University Prague Hradec Kralove Czech Republic

Department of Transplant Surgery Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Transplantation and Tissue Bank University Hospital Motol Prague Czech Republic

Department of Vascular Surgery Na Homolce Hospital Prague Czech Republic

Tissue Bank University Hospital Hradec Králové Czech Republic

Transplant Center University Hospital and Faculty of Medicine Hradec Kralove Charles University Prague Hradec Kralove Czech Republic

Transplants Coordinating Center Prague Czech Republic

References provided by Crossref.org

Viability of Human Arterial Grafts Monitored by Comet Assay

Use of a Silver-Impregnated Vascular Graft: Single-Center Experience

Cell Viability Assessment Using Fluorescence Vital Dyes and Confocal Microscopy in Evaluating Freezing and Thawing Protocols Used in Cryopreservation of Allogeneic Venous Grafts

The Effect of Different Thawing Rates on Cryopreserved Human Iliac Arteries Allograft's Structural Damage and Mechanical Properties

Influence of the new standardized clinical cryopreservation/slow thawing protocol on immunogenicity of arterial allografts in rats