The ability of autologous nerve segments interposed between allografts, to increase the total nerve-gap distance, was studied. Sciatic nerve allografts were carried out in a rat model. A 15-mm nerve gap was repaired with a 25-mm nerve graft (interposed group: allo-auto-allograft; control group: allo-allo-allograft). Cyclosporin was given for 12 weeks. Nerve regeneration was evaluated using the weight of the anterior tibial muscle and histologic, morphometric and immunohistochemical analyses at 12, 13, 14, 15, 16, 20, and 24 weeks. Nerve regeneration in the interposed group was statistically significantly better than that in the control group. The authors concluded that a nerve allograft with interposed autograft may enhance nerve regeneration in this model, because of the migration of host-derived Schwann cells into the graft from not only the proximal and distal host nerve stumps, but also the interposed autograft.
KEYWORDS
Peripheral nerve allograft - nerve regeneration - interposed nerve graft - immunohistochemistry
REFERENCES
-
1
Pollard J D, Mcleod J G.
Fresh and predegenerate nerve allografts and isografts in trembler mice.
Muscle Nerve.
1981;
4
274-281
-
2
Zalewski A A, Gulati A K.
Evaluation of histocompatibility as a factor in the repair of nerve with a frozen nerve allograft.
J Neurosurg.
1982;
56
550-554
-
3
Mackinnon S E, Hudson A R, Falk R E, Kline D, Hunter D.
Peripheral nerve allograft: an assessment of regeneration across pretreated nerve allografts.
Neurosurgery.
1984;
15
690-693
-
4
Mackinnon S E, Midha R, Bain J R, Hunter D A, Wade J A.
An assessment of regeneration across peripheral nerve allografts in rats receiving short courses of Cyclosporin A immunosuppression.
Neuroscience.
1992;
46
585-593
-
5
Midha R, Mackinnon S E, Evans P J et al..
Comparison of regeneration across nerve allografts with temporary or continuous Cyclosporin A immunosuppression.
J Neurosurg.
1993;
78
90-100
-
6
Ishida O, Daves J, Tsu-Min T, Breidenbach W C, Firrell J C.
Regeneration following rejection of peripheral nerve allografts of rats on withdrawal of Cyclosporin A.
Plast Reconstr Surg.
1993;
92
916-926
-
7
Frazier J, Yu L T, Rhee E, Shaw L, LaRossa D, Rostami A.
Extended survival and function of peripheral nerve allografts after cessation of long-term cyclosporin administration in rats.
J Hand Surg.
1993;
18A
100-106
-
8
Mackinnon S E, Doolabh V B, Novak C B, Trulock E P.
Clinical outcome following nerve allograft transplantaion.
Plast Reconstr Surg.
2001;
107
1419-1429
-
9
Yu L T, England J, Hickey W F, Sumner A, Rostami A, Larossa D.
Survival and function of peripheral nerve allografts after cessation of long-term Cyclosporin A immunosuppression in rats.
Transpl Proc.
1989;
21
3178-3180
-
10
Takata H, Ishida O, Ochi M, Ikuta Y.
Rejection and regeneration in peripheral nerve homografts in rats after withdrawal of Cyclosporin: morphological and immunohistochemical assessment.
Scand J Plast Reconstr Hand Surg.
1999;
33
373-377
-
11
Ansselin A D, Westland K, Pollard J D.
Low-dose, short-term Cyclosporin A does not protect the Schwann cells of allogenic nerve grafts.
Neurosci Let.
1990;
119
219-222
-
12
Ishida O, Martin A, Firrell J C.
Origin of Schwann cells in peripheral nerve allograft in the rat after withdrawal of Cyclosporin A.
J Reconstr Microsurg.
1993;
9
233-236
-
13
Midha R, Mackinnon S E, Becker L E.
The fate of Schwann cells in peripheral nerve allograft.
J Neurol Exper Neurol.
1994;
53
316-322
-
14
Bain J R, Mackinnon S E, Hudson A R, Falk R E, Falk J A, Hunter D A.
The peripheral nerve allograft: a dose-response curve in the rat immunosuppressed with Cyclosporin A.
Plast Reconstr Surg.
1988;
82
447-455
-
15
Bacus S S, Ruby S G, Weinberg D S, Chin D, Ortiz R, Bacus J W.
HER-2/neu oncogene expression and proliferation in breast cancers.
Am J Pathol.
1990;
137
103-111
-
16
Bain J R, Mackinnon S E, Hudson A R, Falk R E, Falk J A, Hunter D A.
The peripheral nerve allograft: an assessment of regeneration across nerve allografts in rats immunosuppressed with Cyclosporin A.
Plast Reconstr Surg.
1988;
82
1052-1066
-
17
Ishida O, Ochi M, Miyamoto Y, Ikuta Y, Akiyama M.
Suppression by cyclosporine of cellular and humoral reactivity after peripheral nerve allografts in mice.
Transplantation.
1989;
48
824-829
-
18
Zalewski A A, Gulati A K.
Survival of nerve and Schwann cells in allografts after cyclosporin A treatment.
Exp Neurol.
1980;
70
219-225
-
19
Berger A, Lassner F.
Peripheral nerve allografts: survey of present state in an experimental model of the rat.
Microsurgery.
1994;
15
773-777
-
20
Katsube K, Doi K, Fukumoto T, Fujikura Y, Shigetomi M, Kawai S.
Successful nerve regeneration and persistence of donor cells after a limited course of immunosuppression in rat peripheral nerve allografts.
Transplantation.
1998;
66
772-777
-
21
Aguayo A J, Attiwell M, Trecarten J, Perkins S, Bray G M.
Abnormal myelination in transplanted trembler mouse Schwann cells.
Nature.
1977;
265
73-75
-
22
Gulati A K.
Evaluation of acellular and cellular nerve grafts in repair of rat peripheral nerve.
J Neurosurg.
1988;
68
117-123
-
23
Smahel J, Jentsch B.
Stimulation of peripheral nerve regeneration by an isolated nerve segment.
Ann Plast Surg.
1986;
16
494-501
-
24
Calder J S, Green C J.
Nerve-muscle sandwich grafts: the importance of Schwann cells in peripheral nerve regeneration through muscle basal lamina conduits.
J Hand Surg.
1995;
20B
423-428
-
25
Maeda T, Mackinnon S E, Best T J, Evans P J, Hunter D A, Midha R TR.
Regeneration across stepping-stone nerve grafts.
Brain Res.
1993;
618
196-202
-
26
Francel P C, Francel T J, Mackinnon S E, Hertl C.
Enhancing nerve regeneration across a silicone tube conduit by using interposed short-segment nerve grafts.
J Neurosurg.
1997;
87
887-892
-
27
Frostick S P, Green C J.
Cyclosporin in the prevention of rejection of nerve allografts in rat.
IRCS Med Sci.
1985;
13
267-268
Naoki SugitaM.D.
Department of Orthopaedic Surgery, JR Hiroshima General Hospital
3-1-36, Futabanosato, Higashi-ku
Hiroshima 732-0057, Japan
