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Ann Thorac Surg 2003;76:959-966
© 2003 The Society of Thoracic Surgeons

Review

Preventing saphenous vein graft failure: does gene therapy have a role?

Enoch F. Akowuah, MRCSa*, Paul J. Sheridan, MRCPa, Graham J. Cooper, MDb, Christopher Newman, PhDa

a Cardiovascular Research Group, The University of Sheffield, Sheffield, United Kingdom
b Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield, United Kingdom

* Address reprint requests to Dr Akowuah, Cardiovascular Research Group, Clinical Sciences North, Northern General Hospital, Herries Rd, Sheffield S5 7AU, UK
e-mail: akowuah{at}yahoo.com

Gene therapy potentially allows local delivery and expression of cytokines, growth factors, and other mediators. In spite of increasing knowledge of the human genome, applications in clinical practice are only just beginning. The main limitations of effective clinical gene therapy are safety and low transfection efficiency. Saphenous vein grafts permit the transfection of the conduit ex vivo. This allows a variety of transfection techniques to be used, enhancing the transfection efficiency while limiting the risk of systemic complications. This review examines the potential mechanisms of gene delivery and genetic targets that may be applied to saphenous vein graft failure.




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