Since our knowledge about the use of skin grafts to treat burning wounds (and a lot of other wounds too) has grown, I thought I should try to provide more information about other types of grafts starting with vascular grafts.
Before I get into details, I need to talk about some terms which you might need to get acquainted with/ Grafting tissue means that tissue is taken from one person and then transplanted into that same person or another person.
Allograft syn. homograft: a term used when tissue is taken from one person and transplanted into another. This tissue can be taken from a person who still has circulation or it can be from someone who’s recently deceased.
Autograft syn. autotransplantation: tissue is taken from one person and transplanted in that same person.
Just like any transplantation there can be an immune response to a transplanted graft which is rejection. This doesn’t happen with an autograft as the tissue there is taken and transplanted into the same person.
So what is a vascular graft?
A vascular graft means that a part of an artery or a vein is taken from a person and then transplanted into another or taken to a tissue bank. The goal of a vascular graft is to treat a patient who has any sort of issue regarding blood flow. Usually patients with atherosclerosis will need a vascular graft so that the blood flow can bypass the obstruction and make sure that the patient gets enough blood flow. Patients who need hemodialysis might also need a vascular graft.
Usually an autograft is preferred over an allograft because there’s no risk of rejection however autografts require the patient to undergo two surgeries which might elongate the hospitalization period.
When is a vascular graft used?
There are quite a few pathologies where a graft is used. As mentioned before patients with atherosclerosis especially in the coronary arteries might need a graft.
Patients who need hemodialysis can need an access point which is often a graft. Nowadays there are alternatives: AVflow for example is a nanofiber graft used in hemodialysis patients.
Grafts can also be necessary in the skull, those are called cerebral artery grafts, or in the legs where there are a lot of different bypasses.
To visualize this process I found a video about a coronary artery bypass where you can really see how a superficial eg artery is used to bypass a blockage in a coronary artery. You can see the video below.
Autografting just like any operation comes with a few risks for the patient (embolism or an internal bleeding). On top of these risk we have a few more. When an allograft is transplanted there’s also a risk of rejection and also a risk of infection (due to immunosuppression).
With autografts we have a longer duration of hospitalization because there are two operations that are performed.
Regardless of the risks grafting is definitely something that has become more and more important in the 21st century especially to help patients with atherosclerosis. Since heart and vascular diseases have become more prevalent vascular grafting will definitely prove it’s worth more and more in the future.