Fate of Human Aortic Homografts Ten, Twenty-Four, and Twenty-Seven Months After Transplantation

The use of aortic homografts in the treatment of aneurysmal or occlusive aortic disease is well established.^{5,7,9,12,14,17} Experimental studies^{1,2,11,16,18,19,21-23} concerning the long-term fate of arterial homografts in animals have shown a definite pattern of response—namely, the homograft serves well as an inert, nonviable blood-carrying conduit while undergoing a gradual process of degeneration and partial replacement by an invasive and circumferential growth of fibrous connective tissue from the host.

Observations concerning the fate of human aortic homografts have been few. Gwathmey¹³ has reported the occurrence of aneurysm formation due to subacute bacterial infection in a human aortic homograft five months after transplantation, and others⁹ have expressed concern regarding the occurrence of late degenerative changes which have resulted in various complications. De Bakey,⁶ in a study of 10 aortic homografts from 1 to 360 days after transplantation, observed that the human aortic homograft loses its structural identity