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Mason W, Levin AM, Buhl K, Ouchi T, Parker B, Tan J, Ashammakhi N, Jones LR. Translational Research Techniques for the Facial Plastic Surgeon: An Overview. Facial Plast Surg 2023; 39:466-473. [PMID: 37339663 DOI: 10.1055/a-2113-5023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
The field of facial plastic and reconstructive surgery (FPRS) is an incredibly diverse, multispecialty field that seeks innovative and novel solutions for the management of physical defects on the head and neck. To aid in the advancement of medical and surgical treatments for these defects, there has been a recent emphasis on the importance of translational research. With recent technological advancements, there are now a myriad of research techniques that are widely accessible for physician and scientist use in translational research. Such techniques include integrated multiomics, advanced cell culture and microfluidic tissue models, established animal models, and emerging computer models generated using bioinformatics. This study discusses these various research techniques and how they have and can be used for research in the context of various important diseases within the field of FPRS.
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Affiliation(s)
- William Mason
- Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan
| | - Albert M Levin
- Department of Public Health Science, Henry Ford Health, Detroit, Michigan
- Center for Bioinformatics, Henry Ford Health, Detroit, Michigan
| | - Katherine Buhl
- Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan
| | - Takahiro Ouchi
- Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan
| | - Bianca Parker
- Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan
| | - Jessica Tan
- Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan
| | - Nureddin Ashammakhi
- Institute for Quantitative Health Science and Engineering, Michigan State University, Michigan
- Department of Biomedical Engineering, College of Engineering, Michigan State University, Michigan
- College of Human Medicine, Michigan State University, Michigan
| | - Lamont R Jones
- Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan
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Panayi AC, Knoedler S, Kauke-Navarro M, Haug V, Obed D, Pomahac B. Face transplantation: a bibliometric analysis of the top 100 most cited articles. EUROPEAN JOURNAL OF PLASTIC SURGERY 2023. [DOI: 10.1007/s00238-023-02045-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Sun S, Lu D, Zhong H, Li C, Yang N, Huang B, Ni S, Li X. Donors for nerve transplantation in craniofacial soft tissue injuries. Front Bioeng Biotechnol 2022; 10:978980. [PMID: 36159691 PMCID: PMC9490317 DOI: 10.3389/fbioe.2022.978980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Neural tissue is an important soft tissue; for instance, craniofacial nerves govern several aspects of human behavior, including the expression of speech, emotion transmission, sensation, and motor function. Therefore, nerve repair to promote functional recovery after craniofacial soft tissue injuries is indispensable. However, the repair and regeneration of craniofacial nerves are challenging due to their intricate anatomical and physiological characteristics. Currently, nerve transplantation is an irreplaceable treatment for segmental nerve defects. With the development of emerging technologies, transplantation donors have become more diverse. The present article reviews the traditional and emerging alternative materials aimed at advancing cutting-edge research on craniofacial nerve repair and facilitating the transition from the laboratory to the clinic. It also provides a reference for donor selection for nerve repair after clinical craniofacial soft tissue injuries. We found that autografts are still widely accepted as the first options for segmental nerve defects. However, allogeneic composite functional units have a strong advantage for nerve transplantation for nerve defects accompanied by several tissue damages or loss. As an alternative to autografts, decellularized tissue has attracted increasing attention because of its low immunogenicity. Nerve conduits have been developed from traditional autologous tissue to composite conduits based on various synthetic materials, with developments in tissue engineering technology. Nerve conduits have great potential to replace traditional donors because their structures are more consistent with the physiological microenvironment and show self-regulation performance with improvements in 3D technology. New materials, such as hydrogels and nanomaterials, have attracted increasing attention in the biomedical field. Their biocompatibility and stimuli-responsiveness have been gradually explored by researchers in the regeneration and regulation of neural networks.
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Affiliation(s)
- Sishuai Sun
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Di Lu
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Hanlin Zhong
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Chao Li
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Ning Yang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Bin Huang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Shilei Ni
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
- *Correspondence: Shilei Ni, ; Xingang Li,
| | - Xingang Li
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Jinan Microecological Biomedicine Shandong Laboratory and Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
- *Correspondence: Shilei Ni, ; Xingang Li,
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Abstract
PURPOSE OF REVIEW Face transplantation represents vascularized composite allotransplantation (VCA) organ and became one of the most rewarding reconstructive options for severely disfigured patients. This review summarizes the past, current and future challenges of face transplantation, based on our experience and literature reports. RECENT FINDINGS In 2005, first partial face transplantation was reported by French team. In 2008, we have performed the US first near-total face transplantation. Currently, more than 40 face transplant cases were reported worldwide. Based on the outcomes of our three patients and the literature reports, face transplantation improved aesthetics, function and the quality of life of face transplant patients. However, there are still many challenges encountered including the side effects of immunosuppressive protocols, the psychological and social problems as well as the financial challenges which need to be address in the near future to maintain face transplantation in the armamentarium of reconstructive surgery. SUMMARY Currently, feasibility of face transplantation was confirmed; however, the life-long immunosuppressive protocols bearing serious side effects are still required to prevent face rejection. Thus, for the future of face and other VCA, novel approaches of cell-based therapies or engineered scaffolds should be developed to make face transplantation safer.
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Heineman J, Bueno EM, Kiwanuka H, Carty MJ, Sampson CE, Pribaz JJ, Pomahac B, Talbot SG. All hands on deck: Hand replantation versus transplantation. SAGE Open Med 2020; 8:2050312120926351. [PMID: 32537157 PMCID: PMC7268554 DOI: 10.1177/2050312120926351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 01/07/2023] Open
Abstract
Objectives: Our hands play a remarkable role in our activities of daily living and the
make-up of our identities. In the United States, an estimated 41,000
individuals live with upper limb loss. Our expanding experience in limb
transplantation—including operative techniques, rehabilitation, and expected
outcomes—has often been based on our past experience with replantation.
Here, we undertake a systematic review of replantation with transplantation
in an attempt to better understand the determinants of outcome for each and
to provide a summary of the data to this point. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines, we conducted PubMed searches from 1964 to 2013 for articles in
English. In total, 53 primary and secondary source articles were found to
involve surgical repair (either replantation or transplantation) for
complete amputations at the wrist and forearm levels. All were read and
analyzed. Results: Hand replantations and transplantations were compared with respect to
pre-operative considerations, surgical techniques, post-operative
considerations and outcomes, including motor, sensation, cosmesis, patient
satisfaction/quality of life, adverse events/side effects, financial costs,
and overall function. While comparison of data is limited by heterogeneity,
these data support our belief that good outcomes depend on patient
expectations and commitment. Conclusion: When possible, hand replantation remains the primary option after acute
amputation. However, when replantation fails or is not possible, hand
transplantation appears to provide at least equal outcomes. Patient
commitment, realistic expectations, and physician competence must coincide
to achieve the best possible outcomes for both hand replantation and
transplantation.
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Affiliation(s)
- John Heineman
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ericka M Bueno
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Harriet Kiwanuka
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew J Carty
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Christian E Sampson
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Julian J Pribaz
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Bohdan Pomahac
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Simon G Talbot
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
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Preclinical Animal Models in Facial Transplantation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2455. [PMID: 31942408 PMCID: PMC6908387 DOI: 10.1097/gox.0000000000002455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/24/2019] [Indexed: 12/30/2022]
Abstract
The technical feasibility and clinical applicability of facial transplantation (FT) have been demonstrated, yet animal models with different technical nuances and allograft compositions continue to be developed. We sought to provide a comprehensive appraisal of the current scope and value of animal models in FT.
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Demonstration of technical feasibility and viability of whole eye transplantation in a rodent model. J Plast Reconstr Aesthet Surg 2019; 72:1640-1650. [PMID: 31377202 DOI: 10.1016/j.bjps.2019.05.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 04/17/2019] [Accepted: 05/02/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Whole eye transplantation (WET) holds promise for vision restoration in devastating/disabling visual loss (congenital or traumatic) not amenable to surgical or neuroprosthetic treatment options. The eye includes multiple tissues with distinct embryonic lineage and differential antigenicity. Anatomically and immunologically, the eye is unique due to its avascular (cornea) and highly vascular (retina) components. Our goal was to establish technical feasibility, demonstrate graft viability, and evaluate histologic changes in ocular tissues/adnexae in a novel experimental model of WET that included globe, adnexal, optic nerve (ON), and periorbital soft tissues. METHODS Outbred Sprague-Dawley rats (n = 5) received heterotopic vascularized WET from donors. Each WET included the entire globe, adnexa, ON, and periorbital soft tissues supplied by the common carotid artery and external jugular vein. Viability and perfusion were confirmed by clinical examination, angiography and magnetic resonance imaging (MRI). Globe, adnexal, and periorbital tissues were analyzed for histopathologic changes, and the ON was examined for neuro-regeneration at study endpoint (30 days) or Banff Grade 3 rejection in the periorbital skin (whichever was earlier). RESULTS Gross examination confirmed transplant viability and corneal transparency. Average operative duration was 64.0 ± 5.8 min. Average ischemia time was 26.0 ± 4.2 min. MRI revealed loss of globe volume by 36.0 ± 2.8% after transplantation. Histopathology of globe and adnexal tissues showed unique and differential patterns of inflammatory cell infiltration. The ON revealed a neurodegeneration pattern. CONCLUSION The present study is the first in the literature to establish an experimental model of WET. This model holds significant potential in investigating mechanistic pathways, monitoring strategies or developing management approaches involving ocular viability, immune rejection, and ON regeneration after WET.
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Pei YC, Cheng YP, Chen JL, Lin CH, Wen CJ, Huang JJ. Early recovery of neuronal functioning in the sensory cortex after nerve reconstruction surgery. Restor Neurol Neurosci 2019; 37:409-419. [PMID: 31322584 PMCID: PMC6700653 DOI: 10.3233/rnn-190914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Nerve reconstructive surgery induces a transient loss and a prolonged and a gradual return of sensory inputs to the brain. It is unknown whether, following this massive peripheral denervation, the brain will experience a prolonged period of severe, intrinsic dysfunction. OBJECTIVE We aim to investigate the mechanisms of return of processing function in cortical neurons. METHODS We used the whisker model in rats to evaluate the functional recovery in the somatosensory cortex after a nerve reconstruction surgery. Multi-unit recording in the barrel cortex was performed in lightly anesthetized rats while their whiskers were stimulated by a whisker stimulator. RESULTS We observed a loss of neuronal responses to whisker stimulation 1 week after surgery, which started to recover 2 weeks after surgery. Following the surgery, only 11.8% of units had principle whiskers (PWs) returned to their original status while 17.7% had PWs different from their original status, indicating the effect of aberrant reinnervation on the whisker response map. CONCLUSIONS Robust neuronal responses to sensory stimulation even when only sparse sensory inputs are available in the early recovery phase. During this phase, aberrant reinnervation induces disorganized whisker tuning, a finding that might be account for the hypoesthesia and paresthesia during early recovery after nerve reconstruction.
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Affiliation(s)
- Yu-Chen Pei
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, Chang Gung University, Taoyuan City, Taiwan.,Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan
| | - Yu-Po Cheng
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Ji-Lin Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Cheng-Hung Lin
- School of Medicine, Chang Gung University, Taoyuan City, Taiwan.,Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Chih-Jen Wen
- Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.,Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Jian-Jia Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, Chang Gung University, Taoyuan City, Taiwan.,Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
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A Porcine Orthotopic Forelimb Vascularized Composite Allotransplantation Model. Plast Reconstr Surg 2016; 138:461e-471e. [DOI: 10.1097/prs.0000000000002451] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kulahci Y, Altuntas SH, Karagoz H, Cwykiel JM, Zor F, Siemionow M. A new total hemiface allotransplantation model in rats. Microsurgery 2016; 36:230-8. [PMID: 26797916 DOI: 10.1002/micr.22527] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/06/2015] [Accepted: 10/15/2015] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Vascularized composite allotransplantation (VCA), a new reconstructive option for patients suffering from extensive facial defects leads to superior functional and aesthetic outcomes compared to the standard autologous reconstruction. Among VCA recipients, each case involves different facial structures and tissues depending on the patient's injury, thus drawing conclusions on the mechanism of immune interactions between the donor and recipient is challenging. This study introduces a new total hemiface VCA model, including scalp, external ear, mystacial pad, premaxilla, upper/lower lids, nose, and upper/lower lips to evaluate the effect of transplantation of multitissue VCA on the recipient's immune response. MATERIAL AND METHODS Ten hemiface allotransplantations were performed in two groups between Lewis-Lewis (isograft) and LBN-Lewis (allograft) rats. Cyclosporine A (CsA) monotherapy was applied in the allograft group to prevent rejection. RESULTS All flaps survived up to 100 days post-transplant. The mean warm ischemia time was 45 minutes. Histological analysis revealed normal bone, cartilage (ear and nose), conjunctiva, palpebra, and eyelashes. Flow cytometry confirmed donor-specific chimerism for T cells (CD4/RT1(n) and CD8/RT1(n)) and B cells (CD45RA/RT1(n)) in the peripheral blood of all rats in the allotransplantation group. At post-transplant day 7, chimerism levels were at 1.68% for CD4/RT1(n) , 0.46% for CD8/RT1(n) and 0.64% for CD45RA/RT1(n). However, chimerism levels for CD4/RT1(n), CD8/RT1(n), and CD45RA/RT1(n) populations decreased at long-term follow-up (at post-transplant day 100) to 0.08%, 0.04%, and 0.23%, respectively. CONCLUSION The feasibility and long-term survival of the new hemiface VCA transplantation model was confirmed, donor-specific chimerism and post-transplant tissue changes were evaluated.
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Affiliation(s)
- Yalcin Kulahci
- Department of Hand and Upper Extremity Surgery, Gulhane Military Medical Academy, Ankara, Turkey
| | - Selman H Altuntas
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty, Suleyman Demirel University, Isparta, Turkey
| | - Huseyin Karagoz
- Department of Plastic, Reconstructive and Aesthetic Surgery, Haydarpasa Training Hospital, Gulhane Military Medical Academy, Istanbul, Turkey
| | - Joanna M Cwykiel
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL
| | - Fatih Zor
- Department of Plastic, Reconstructive and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey
| | - Maria Siemionow
- Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL
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Ancillary procedures necessary for translational research in experimental craniomaxillofacial surgery. J Craniofac Surg 2015; 25:2043-50. [PMID: 25377964 DOI: 10.1097/scs.0000000000000935] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Swine are often regarded as having analogous facial skeletons to humans and therefore serve as an ideal animal model for translational investigation. However, there is a dearth of literature describing the pertinent ancillary procedures required for craniomaxillofacial research. With this in mind, our objective was to evaluate all necessary procedures required for perioperative management and animal safety related to experimental craniomaxillofacial surgical procedures such as orthotopic, maxillofacial transplantation. METHODS Miniature swine (n = 9) were used to investigate perioperative airway management, methods for providing nutrition, and long-dwelling intravenous access. Flap perfusion using near-infrared laser angiography and facial nerve assessment with electromyoneurography were explored. RESULTS Bivona tracheostomy was deemed appropriate versus Shiley because soft, wire-reinforced tubing reduced the incidence of tracheal necrosis. Percutaneous endoscopic gastrostomy tube, as opposed to esophagostomy, provided a reliable route for postoperative feeding. Femoral venous access with dorsal tunneling proved to be an ideal option being far from pertinent neck vessels. Laser angiography was beneficial for real-time evaluation of graft perfusion. Facial electromyoneurography techniques for tracing capture were found most optimal using percutaneous leads near the oral commissure.Experience shows that ancillary procedures are critical, and malpositioning of devices may lead to irreversible sequelae with premature animal death. CONCLUSIONS Face-jaw-teeth transplantation in swine is a complicated procedure that demands special attention to airway, feeding, and intravascular access. It is critical that each ancillary procedure be performed by a dedicated team familiar with relevant anatomy and protocol. Emphasis should be placed on secure skin-level fixation for all tube/lines to minimize risk for dislodgement. A reliable veterinarian team is invaluable and critical for long-term success.
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Zhu H, Xie F, Luo X, Qin L, Sherry Liu X, Scott Levin L, Li Q. Orthotopic forelimb allotransplantation in the rat model. Microsurgery 2015; 36:672-675. [PMID: 26566967 DOI: 10.1002/micr.22530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 06/17/2015] [Accepted: 10/19/2015] [Indexed: 12/26/2022]
Abstract
In this report, we present a rat orthotopic forelimb allotransplantation model. Eight forelimbs were transplanted from Brown Norway rats to Lewis rats. Axillary vessels of transplant were used as the vascular pedicles, which were anastomosed to the external jugular vein and common carotid artery of the recipient rat. The ulnar, radial, and median nerves were also repaired. Among rats, a tapered dose of cyclosporine was administered in five rats. In other three rats, no immunosuppressive therapy was given. The viability and signs of rejection of transplanted forelimbs, sensation recovery, bone healing, and histology were assessed up to the 90th postoperative day. All of rats but one survived surgery. All of transplanted forelimbs survived. In the rats treated with cyclosporine the transplanted forelimbs achieved long-term survival with motion and sensation recovery. On 90th day after surgery, bone healing was achieved. There was no sign of rejection in histology. In the rats without cyclosporine treatment, the transplanted forelimbs experienced tissue necrosis started from day 12 postoperatively. This experimental study showed the feasibility of orthotopic forelimb allotransplantation in the rat model. © 2015 Wiley Periodicals, Inc. Microsurgery 36:672-675, 2016.
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Affiliation(s)
- Hainan Zhu
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Feng Xie
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xusong Luo
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Ling Qin
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - X Sherry Liu
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lawrence Scott Levin
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Siemionow M, Zor F. Allotransplantation. Plast Reconstr Surg 2015. [DOI: 10.1002/9781118655412.ch12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Transplantation of the Mystacial Pad. Plast Reconstr Surg 2015. [DOI: 10.1007/978-1-4471-6335-0_40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Composite Orbital and Periorbital Allotransplantation Model. Plast Reconstr Surg 2015. [DOI: 10.1007/978-1-4471-6335-0_45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zor F, Bozkurt M. Composite Osseomusculocutaneous Midface Allotransplantation Model with Motor and Sensory Units. Plast Reconstr Surg 2015. [DOI: 10.1007/978-1-4471-6335-0_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Full Face Transplant Model in Rats. Plast Reconstr Surg 2015. [DOI: 10.1007/978-1-4471-6335-0_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kulahci Y, Siemionow MZ. Composite Hemiface/Mandible/Tongue Allotransplantation Model in Rats. Plast Reconstr Surg 2015. [DOI: 10.1007/978-1-4471-6335-0_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vascularized Composite Allotransplantation Models. Plast Reconstr Surg 2015. [DOI: 10.1007/978-1-4471-6335-0_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Busnardo FDF, Coltro PS, Olivan MV, Barreiro GC, Baptista RR, Ferreira MC, Gemperli R. Face transplantation in rats. Reproducibility of the experimental model in Brazil. Acta Cir Bras 2014; 29:532-7. [DOI: 10.1590/s0102-86502014000800009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/11/2014] [Indexed: 11/22/2022] Open
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Kökten T, Bécavin T, Keller L, Weickert JL, Kuchler-Bopp S, Lesot H. Immunomodulation stimulates the innervation of engineered tooth organ. PLoS One 2014; 9:e86011. [PMID: 24465840 PMCID: PMC3899083 DOI: 10.1371/journal.pone.0086011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 12/04/2013] [Indexed: 01/24/2023] Open
Abstract
The sensory innervation of the dental mesenchyme is essential for tooth function and protection. Sensory innervation of the dental pulp is mediated by axons originating from the trigeminal ganglia and is strictly regulated in time. Teeth can develop from cultured re-associations between dissociated dental epithelial and mesenchymal cells from Embryonic Day 14 mouse molars, after implantation under the skin of adult ICR mice. In these conditions however, the innervation of the dental mesenchyme did not occur spontaneously. In order to go further with this question, complementary experimental approaches were designed. Cultured cell re-associations were implanted together with trigeminal ganglia for one or two weeks. Although axonal growth was regularly observed extending from the trigeminal ganglia to all around the forming teeth, the presence of axons in the dental mesenchyme was detected in less than 2.5% of samples after two weeks, demonstrating a specific impairment of their entering the dental mesenchyme. In clinical context, immunosuppressive therapy using cyclosporin A was found to accelerate the innervation of transplanted tissues. Indeed, when cultured cell re-associations and trigeminal ganglia were co-implanted in cyclosporin A-treated ICR mice, nerve fibers were detected in the dental pulp, even reaching odontoblasts after one week. However, cyclosporin A shows multiple effects, including direct ones on nerve growth. To test whether there may be a direct functional relationship between immunomodulation and innervation, cell re-associations and trigeminal ganglia were co-implanted in immunocompromised Nude mice. In these conditions as well, the innervation of the dental mesenchyme was observed already after one week of implantation, but axons reached the odontoblast layer after two weeks only. This study demonstrated that immunodepression per se does stimulate the innervation of the dental mesenchyme.
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Affiliation(s)
- Tunay Kökten
- Institut National de la Santé Et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR)1109, team “Osteoarticular and Dental Regenerative NanoMedicine”, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Thibault Bécavin
- Institut National de la Santé Et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR)1109, team “Osteoarticular and Dental Regenerative NanoMedicine”, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Laetitia Keller
- Institut National de la Santé Et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR)1109, team “Osteoarticular and Dental Regenerative NanoMedicine”, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | - Jean-Luc Weickert
- Service de Microscopie Electronique, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM Unité (U)964, Centre National de la Recherche Scientifique (CNRS) UMR1704, Université de Strasbourg, Illkirch, France
| | - Sabine Kuchler-Bopp
- Institut National de la Santé Et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR)1109, team “Osteoarticular and Dental Regenerative NanoMedicine”, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Hervé Lesot
- Institut National de la Santé Et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR)1109, team “Osteoarticular and Dental Regenerative NanoMedicine”, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
- * E-mail:
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Siemionow M. Impact of reconstructive transplantation on the future of plastic and reconstructive surgery. Clin Plast Surg 2013; 39:425-34. [PMID: 23036293 DOI: 10.1016/j.cps.2012.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article summarizes the current knowledge on the new developing field of reconstructive transplantation. A brief outline of vascularized composite allografts (VCA) such as human hand, face, larynx, and abdominal wall transplants is provided. The clinical applications and indications for these new reconstructive transplantation procedures are outlined. The advantages, disadvantages, and complications and concerns surrounding clinical VCA are discussed. Finally, the impact of reconstructive transplantation on the future of plastic and reconstructive surgery is presented.
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Affiliation(s)
- Maria Siemionow
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, 9500 Euclid Avenue, Desk NA-21, Cleveland, OH 44195, USA.
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Brandacher G, Grahammer J, Sucher R, Lee WPA. Animal models for basic and translational research in reconstructive transplantation. ACTA ACUST UNITED AC 2012; 96:39-50. [PMID: 22457176 DOI: 10.1002/bdrc.21002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reconstructive transplantation represents a bona fide option for select patients with devastating tissue loss, which could better restore the appearance, anatomy, and function than any other conventional treatment currently available. Despite favorable outcomes, broad clinical application of reconstructive transplantation is limited by the potential side effects of chronic multidrug immunosuppression. Thus, any reconstructive measures to improve these non-life-threatening conditions must address a delicate balance of risks and benefits. Today, several exciting novel therapeutic strategies, such as the implementation of cellular therapies including bone marrow or stem cells that integrate the concepts of immune regulation with those of nerve regeneration, are on the horizon. The development of reliable and reproducible small and large animal models is essential for the study of the unique immunological and biological aspects of vascularized composite allografts and to translate such novel immunoregulatory and tolerance-inducing strategies and therapeutic concepts from the bench to bedside. This review provides an overview of the multitude of small and large animal models that have been particularly designed for basic and translational research related to reconstructive transplantation.
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Affiliation(s)
- Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryand 21205, USA.
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Bozkurt M, Klimczak A, Nasir S, Zor F, Krokowi̇cz L, Siemionow M. Composite osseomusculocutaneous sternum, ribs, thymus, pectoralis muscles, and skin allotransplantation model of bone marrow transplantation. Microsurgery 2012; 33:43-50. [DOI: 10.1002/micr.22023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 06/04/2012] [Accepted: 06/08/2012] [Indexed: 11/06/2022]
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Rodriguez-Lorenzo A, Audolfsson T, Rozen S, Kildal M, Nowinski D. Supraorbitary to infraorbitary nerve transfer for restoration of midface sensation in face transplantation: Cadaver feasibility study. Microsurgery 2012; 32:309-13. [DOI: 10.1002/micr.21944] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 11/04/2011] [Accepted: 11/09/2011] [Indexed: 11/06/2022]
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