The changes developing in functioning saphenous vein transplants were studied by light and electron microscopy in three human cases. The degenerative signs appearing in the smooth muscle cells of the graft, as well as the glycogen accumulation and the changes of the cell organelles are discussed. Beside the thick elastic fibres visible under the light microscope in the graft functioning for 22 months the electron microscope revealed as a characteristic lesion the development of elastic fibres among the young collagenous fibres. It is emphasized that degenerated, sclerotic and varicose veins should not be used as grafts since no good results can be expected from them.
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