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However, current preservation methods, particularly cryopreservation, lead to substantial endothelial damage and poor clinical outcomes. This study evaluated the long-term efficacy of an N-acetylhistidine-buffered, potassium-chloride-enriched and amino-acid-fortified solution augmented with iron chelators, as an advanced preservation solution (NTK-Chel), compared to histidine-tryptophan-ketoglutarate (HTK) and normal saline for vascular graft storage. Abdominal aortae from male Wistar rats (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200975) were stored for 2\u00a0weeks at 4\u00a0\u00b0C in NTK-Chel (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200924), HTK (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200926), or normal saline (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200925), then transplanted orthotopically. Grafts were harvested at 8, 16, and 26\u00a0weeks post-transplantation for vascular function testing and histological analysis. Upon explantation, smooth muscle contractility was severely impaired in all preservation solutions at 8, 16, and 26\u00a0weeks post-transplantation. At 8\u00a0weeks, only NTK-Chel-preserved grafts demonstrated detectable contractile responses to KCl, though these did not meet criteria for comprehensive vasomotor testing. By 16 and 26\u00a0weeks, all grafts had lost measurable contractility. The NTK-Chel group was associated with significantly reduced intimal hyperplasia compared to HTK and normal saline, particularly at 8 and 26\u00a0weeks. However, progressive smooth muscle cell loss occurred in all groups, with NTK-Chel showing only delayed rather than prevented degeneration. While NTK-Chel resulted in significantly less intimal hyperplasia compared to conventional solutions, prolonged cold storage combined with transplantation-associated remodeling ultimately compromises long-term vasomotor function regardless of preservation strategy.\n                  <\/jats:p>","DOI":"10.1007\/s00210-026-05368-9","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:12:37Z","timestamp":1777450357000},"page":"15557-15569","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of aortic grafts after 2-week storage in a rat model of orthotopic aortic transplantation"],"prefix":"10.1007","volume":"399","author":[{"given":"Manuel J.","family":"Santander","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narges","family":"Waezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Rauen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Voigt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard C.","family":"Danner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Kutschka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Sosalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4281-0960","authenticated-orcid":false,"given":"Ahmad Fawad","family":"Jebran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomislav","family":"Stojanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"5368_CR1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2018-000780","volume":"5","author":"W Ali","year":"2018","unstructured":"Ali W, Voisine P, Olsen P et al (2018) DuraGraft vascular conduit preservation solution in patients undergoing coronary artery bypass grafting: rationale and design of a within-patient randomised multicentre trial. 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