Functional Outcomes following Multiple Acute Rejections in Experimental Vascularized Composite Allotransplantation

• DOI: 10.1097/prs.0b013e3182879e85
• Publication Date: 2013-04-30T12:34:19Z
• Authors: Jignesh V. Unadkat; Dennis Bourbeau; Paul N. Afrooz; Mario G. Solari; Kia M. Washington; Benson J. Pulikko...; Douglas J. Weber; W. P. Andrew Lee
• Keywords: Muscle Atrophy; Allotransplantation; Immunosuppression

Vascularized composite allotransplantation has become a clinical reality. Patients undergoing vascularized have modest functional return. Most patients had multiple acute rejections. The effect of rejections influencing outcomes is unknown. This study systematically analyzes the effects on outcome.Rat orthotopic hind-limb transplants were performed from Brown-Norway to Lewis rats. Group 1 consisted isografts. In group 2, daily cyclosporine was administered prevent rejection. 3, recipients did not receive regular immunosuppression but received only pulsed and dexamethasone rescue endpoint 90 days. Muscle sciatic nerve biopsy specimens taken for histologic analyses. Hind-limb function assessed using axon density, conduction velocity, muscle force generated by gastrocnemius muscle. Novel video kinematics used analyze gait.By endpoint, 3 animals 17 ± 5.1 showed significant atrophy fibrosis in compared with groups 2. Withdrawal pin prick evident days 31 1.2, 30 2.3, 3.7 1, respectively. At there no difference density or velocity among three groups, significantly less 3. Gait abnormal other groups.In this study, induced consequent decreased function. emphasizes importance preventing rejection achieve optimum following allotransplantation.