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1.
J Reconstr Microsurg ; 24(8): 545-50, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18819061

ABSTRACT

Neural stem cells show a remarkable aptitude for integration and appropriate differentiation at sites of cellular injury in central nervous system (CNS) disease models. In contrast, reports of neural stem cell applications in peripheral nerve injury models are sparse. In this study we sought to determine if the C17.2 cell line would respond to cues in the microenvironment of the injured peripheral nerve and enhance neuronal regeneration in rodent sciatic nerve injury models. We transplanted C17.2 into several sciatic nerve injury models in 45 nude rats, including nerve transection, nerve crush, and nerve gap models. Twelve of the animals in this study developed large tumors at the site of neural stem cell transplants. Histologically, the tumors resembled neuroblastomas. The tumors were confirmed to be of transplanted cell origin by positive beta-galactosidase staining. Tumors occurred only in models where the nerve remained intact or where continuity of the nerve was restored. We concluded that C17.2 transplantation into peripheral nerve injury models resulted in a high rate of tumor formation. This study demonstrates that the success of neural precursor transplants in the CNS cannot necessarily be extrapolated to the peripheral nervous system.


Subject(s)
Cell Differentiation , Neuroblastoma/etiology , Neurons/physiology , Peripheral Nervous System Neoplasms/etiology , Sciatic Nerve/injuries , Stem Cell Transplantation , Stem Cells/cytology , Animals , Cell Line , Disease Models, Animal , Nerve Crush , Nerve Regeneration , Neuroblastoma/diagnosis , Neuroblastoma/pathology , Neurons/cytology , Peripheral Nervous System Neoplasms/diagnosis , Peripheral Nervous System Neoplasms/pathology , Rats , Rats, Nude , Stem Cell Transplantation/adverse effects
2.
Microsurgery ; 26(8): 566-72, 2006.
Article in English | MEDLINE | ID: mdl-17091477

ABSTRACT

The purpose of this article is to review the historical background and clinical status of composite tissue allotransplantation and to discuss the scientific evolution of clinical face transplantation. Composite tissue allotransplantation (CTA) rapidly progressed in the 1980s with the discovery of cyclosporine. Although the most success has been achieved with hand transplantation, others have made progress with allografts of trachea, peripheral nerve, flexor tendon apparatus, vascularized knee, larynx, abdominal wall, and most recently, partial face. The world's first partial face allotransplantation occurred in November 2005 in France. In April of 2006, there was a second performed in China. As of today, there are now multiple institutions with plans to attempt the world's first full facial/scalp transplant. Complete facial/scalp allotransplantation offers a viable alternative for unfortunate individuals suffering severe facial disfigurement and is a product of many decades of experimental research, beginning with rat hindlimb allografts.


Subject(s)
Transplantation, Homologous/history , Animals , Face/surgery , Hindlimb/transplantation , History, 20th Century , History, Ancient , Humans , Rats
3.
Plast Reconstr Surg ; 116(2): 577-89, 2005 Aug.
Article in English | MEDLINE | ID: mdl-16079694

ABSTRACT

BACKGROUND: Both native and engineered cartilage is brittle and fractures easily without perichondrium. The aim of this study was to understand the role of the perichondrium and try to enhance the flexible properties of tissue-engineered cartilage using expanded polytetrafluoroethylene (ePTFE) membrane as a pseudoperichondrium. METHODS: The study was conducted in two phases. In phase I, native swine auricular cartilage of different thicknesses was studied by histologic evaluation and failure testing. Next, isolated perichondrium was bonded to native cartilage slices using fibrin glue or Dermabond and tested to failure. In phase II, swine auricular chondrocytes were suspended in fibrin glue. The chondrocyte-fibrin glue composites were then bound to expanded polytetrafluoroethylene membrane in two trilaminar configurations: In group EC-1, the membrane was in the center, whereas it was on the surfaces in group EC-2. Specimens were implanted into nude mice for 4 weeks, 8 weeks, 12 weeks, and 8 months and subjected to histologic evaluation and failure testing. RESULTS: In phase I, the results demonstrated that perichondrium securely bonded to the cartilage plays an important role in maintaining the flexible nature of elastic cartilage. In phase II, failure testing revealed that specimens in group EC-1 (expanded polytetrafluoroethylene core) were fractured during bending and destroyed after torsion, whereas those in group EC-2 (cartilage core) returned to their original shape without fracturing even after rigorous torsion. Histologic analysis demonstrated that transplanted chondrocytes penetrated into the microporous structure of expanded polytetrafluoroethylene and created a bond to it. CONCLUSION: It is possible to engineer flexible cartilage using expanded polytetrafluoroethylene as a pseudoperichondrium.


Subject(s)
Cartilage , Membranes, Artificial , Tissue Engineering/methods , Animals , Biomechanical Phenomena , Cartilage/physiology , Chondrocytes , Elasticity , Materials Testing , Mice , Mice, Nude , Polytetrafluoroethylene/therapeutic use , Swine
4.
Microsurgery ; 24(6): 448-53, 2004.
Article in English | MEDLINE | ID: mdl-15499552

ABSTRACT

Current rodent models for investigation of limb allotransplantation typically utilize orthotopic whole-limb transplantation, a morbid and time-consuming procedure. Our objective was to design a less morbid rat model to explore the immunological obstacles of limb transplantation, and particularly skin. Twenty lower hindlimbs from 10 donors were transplanted into a heterotopic subcutaneous position into 20 animals (10 isogeneic and 10 allogeneic). Each group was further subdivided to include animals with (n = 5) and without (n = 5) a skin paddle for observation of cutaneous signs of rejection. All grafts in the isogeneic group survived for 100 days, i.e., the endpoint of the study. Allogeneic transplants rejected their allografts at a mean of 12.8 days (with skin) and 20.6 days (without). Our heterotopic limb transplantation model takes less time and is less stressful to the animals, while allowing for early observation of graft skin rejection, when compared to orthotopic whole-limb transplantation.


Subject(s)
Graft Rejection/etiology , Hindlimb/transplantation , Skin Transplantation , Transplantation, Heterotopic , Anastomosis, Surgical , Animals , Biopsy , Femoral Artery/surgery , Femoral Vein/surgery , Graft Rejection/pathology , Graft Survival , Microsurgery , Models, Animal , Necrosis , Rats , Rats, Inbred F344 , Rats, Inbred Lew , Skin/pathology , Skin Transplantation/pathology , Surgical Flaps , Transplantation, Homologous , Transplantation, Isogeneic
5.
Plast Reconstr Surg ; 113(1): 270-6, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14707646

ABSTRACT

Composite-tissue (e.g., hand allograft) allotransplantation is currently limited by the need for immunosuppression to prevent graft rejection. Inducing a state of tolerance in the recipient could potentially eliminate the need for immunosuppression but requires reprogramming of the immunological repertoire of the recipient. Skin is the most antigenic tissue in the body and is consistently refractory to tolerance induction regimens using bone marrow transplantation alone. It was hypothesized that tolerance to skin allografts could be induced in rats by injecting epidermal cells with bone marrow cells during the first 24 hours of life of the recipients. Brown Norway rats (RT1n) served as donors for the epidermal cells, bone marrow cells, and skin grafts. Epidermal cells were injected intraperitoneally and bone marrow cells were injected intravenously into Lewis (RT1l) newborn recipient rats. In control groups, recipients received saline solution with no cells (group I, n = 12), bone marrow cells only (group II, n = 15), or epidermal cells only (group III, n = 15). In the experimental group (group IV, n = 18), recipients received epidermal and bone marrow cells simultaneously. Skin grafts were transplanted from Brown Norway (RT1n) rats to the Lewis (RT1l) rats 8 weeks after cell injections. Skin grafts survived an average of 8.5 days in group I (10 grafts), 9.2 days in group II (12 grafts), and 12 days in group III (14 grafts). Grafts survived 15.5 days (8 to 26 days) in group IV (15 grafts). The difference was statistically significant (p < 0.05). Hair growth was observed in some accepted grafts in group IV but never in the control groups. This is the first report of prolonged survival of skin allografts in a rat model after epidermal and bone marrow cell injections. Survival prolongation was achieved across a major immunological barrier, without irradiation, myeloablation, or immunosuppression. It is concluded that the presentation of skin-specific antigens generated a temporary state of tolerance to the skin in the recipients that could have delayed the rejection of skin allografts.


Subject(s)
Bone Marrow Transplantation/immunology , Epidermis/transplantation , Graft Survival/immunology , Immune Tolerance , Skin Transplantation/immunology , Animals , Animals, Newborn , Epidermal Cells , Epidermis/immunology , Injections, Intraperitoneal , Injections, Intravenous , Isoantigens/administration & dosage , Isoantigens/immunology , Rats , Rats, Inbred BN , Rats, Inbred Lew , Transplantation Conditioning , Transplantation, Homologous/immunology
6.
Transplantation ; 75(1): 25-31, 2003 Jan 15.
Article in English | MEDLINE | ID: mdl-12544866

ABSTRACT

BACKGROUND: The antigenicity of skin is a major obstacle to expanding human composite tissue transplantation. For example, multiple rejection episodes of the skin have been noted in clinical hand transplant patients. We have previously demonstrated tolerance to vascularized musculoskeletal allografts in major histocompatibility complex (MHC)-matched miniature swine treated with 12 days of cyclosporine. This regimen did not reproducibly lead to tolerance to subsequent frozen donor skin grafts. However, such skin grafts did not have a primary vascular supply. The aim of this study was to determine if tolerance to limb allografts with a vascularized skin component could be achieved with MHC matching and a 12-day course of immunosuppression. METHODS: Hind limb grafts harvested with a 100 cm(2) cutaneous paddle were transplanted heterotopically into six MHC-matched, minor antigen-mismatched miniature swine. All animals received a 12-day course of cyclosporine. One control animal was not immunosuppressed. Grafts were evaluated with biweekly biopsies and tissue viability determined by histologic analysis. To test for sensitization, frozen donor skin grafts were applied to all animals that survived to postoperative day 100. RESULTS: All treated animals (n=6) were tolerant to their musculoskeletal allografts at the time of necropsy (>100 days) regardless of the status of the epidermis. One animal demonstrated tolerance to the skin for more than 180 days. The other five animals demonstrated prolonged survival of the epidermal portion of the graft. The control animal rejected the graft epidermis at 10 days postoperatively. Frozen donor skin grafts demonstrated accelerated rejection (<10 days) in three of the animals and led to simultaneous rejection of both the epidermis of the allograft and the skin graft in the long-term tolerant animal. The rejection of the skin grafts did not break tolerance to the musculoskeletal portion in any of the animals. CONCLUSIONS: All animals exhibited indefinite survival of the musculoskeletal portion of their allografts but only prolonged survival of the epidermis. The loss of the graft skin appears to be the result of an isolated immune reaction to the skin, and, in particular, the epidermis. This observation is further substantiated by the accelerated rejection of secondarily placed frozen donor skin grafts.


Subject(s)
Hindlimb/transplantation , Immune Tolerance , Skin Transplantation/immunology , Animals , Models, Animal , Skin/immunology , Skin/pathology , Skin Transplantation/methods , Swine , Transplantation, Homologous
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