2023, Vol. 27 ›› Issue (24): 3920-3925

Clinical application of vascular cryoprotectants

Wang Shan, Wang Cheng, Shi Yehong   

Abstract: BACKGROUND: Cryopreserved allogeneic blood vessels have broad clinical application prospects in vascular transplantation and repair. Cryopreservation is a common method to achieve long-term preservation of allogeneic blood vessels. During cryopreservation, effective cryoprotectants are essential to prevent vascular tissue hypothermia damage and maintain cell viability. However, there is no consensus on the choice of the best cryoprotectant.
OBJECTIVE: To summarize the cryoprotectants used in major vascular tissue banks in recent years and compare their clinical effects, thereby providing a reference for the application of cryopreservation of allogeneic blood vessels in the future.
METHODS: The relevant literature included in CNKI, WanFang, PubMed, and Google Scholar databases from 2015 to 2022 was retrieved by the first author. The Chinese search terms were “allogeneic blood vessels, artery, vein, cryopreservation, cryoprotective agent, cryoinjury, vascular transplantation.” The English search terms were “cryopreservation, blood vessels, vascular allografts, arteries, veins, cryoinjury, cryoprotectants, cryoprotective agents.” The relevant literature at home and abroad on vascular cryoprotectants used in clinic and their short-term and long-term results were searched. Finally, 54 articles were selected for review.
RESULTS AND CONCLUSION: (1) In the study of cryopreservation of blood vessels, a combination of permeable and non-permeable cryoprotectant is often used to reduce damage to the structure of the vessel wall through programmed cooling and rapid thawing. (2) Despite the toxic effects of dimethyl sulfoxide, tissue bank product lists in many countries do not include any cardiovascular tissue cryopreserved with cryoprotectant other than dimethyl sulfoxide alone. At present, there are still many clinical complications after cryopreservation of allogeneic blood vessels for vascular transplantation, and some are even fatal. (3) As an essential component of protective agent, dimethyl sulfoxide is very important to balance its toxic effect and protective effect. Finding a new type of cryoprotectant that is safe, non-toxic and free of xenogeneic antigens is the main direction of current research, which is very important for the clinical development of allogeneic vascular grafts.

Key words: vascular allograft, cryopreservation, cryoprotectant, cryoinjury, vascular transplantation, graft infection, in situ replacement