Summary
Here we describe the orthotopic rat hind-limb transplantation procedure, which seems to be the gold standard in vivo model for composite tissue allotransplantation research.
Abstract
Composite tissue allotransplantation (CTA) now represents a valid therapeutic option after the loss of a hand, forearm or digits and has become a novel therapeutic entity in reconstructive surgery. However, long term high-dose multi-drug immunosuppressive therapy is required to ensure graft survival, bearing the risk of serious side effects which halters broader application. Further progression in this field may depend on better understanding of basic immunology and ischemia reperfusion injury in composite tissue grafts.
To date, orthotopic hind limb transplantation in rats has been the preferred rodent model for reconstructive transplantation (RT), however, it is an extremely demanding procedure that requires extraordinary microsurgical skills for reattachment of vasculature, bones, muscles and nerves.
We have introduced the vascular cuff anastomosis technique to this model, providing a rapid and reliable approach to rat hind limb transplantation. This technique simplifies and shortens the surgical procedure and enables surgeons with basic microsurgical experience to successfully perform the operation with high survival and low complication rates. The technique seems to be well suited for immunological as well as ischemia reperfusion injury (IRI) studies.
Protocol
Discussion
Decades of experimental research have preceded and enabled successful human hand transplantation in the recent past. In 1978, Shapiro et al. developed an orthotopic hind limb transplant model in rats, well suited to study various pathological, physiological, and immunological aspects as well as functional outcome of composite tissue grafts. We have modified the most challenging part of the procedure, namely the vascular anastomosis, by introducing a non-suture cuff technique. When compared to the conventional suture tec…
Disclosures
The authors have nothing to disclose.
Materials
| Material Name | Type | Company | Catalogue Number | Comment |
|---|---|---|---|---|
| Nembutal® | Ovation Pharmaceuticals, Inc. | |||
| Heparin Immuno | Ebewe Pharma | |||
| Custodiol HTK Solution | Essential Pharmaceuticals | |||
| Adventitia Scissors | ASSI | ASSI®SAS-21 R-8T | ||
| Forceps | ASSI | ASSI®JFC-7 | ||
| Dilator Forceps | ASSI | ASSI®D-5AZ | ||
| Polymide Tubes | River Tech Medical | #17; #19 |
References
- Shapiro, R. I., Cerra, F. B. A model for reimplantation and transplantation of a complex organ: the rat hind limb. J Surg Res. 24 (6), 501-506 (1978).
- Petruzzo, P. The international registry on hand and composite tissue transplantation. Transplantation. 86 (4), 487-492 (2008).
- Schneeberger, S. First forearm transplantation: outcome at 3 years. Am J Transplant. 7 (7), 1753-1762 (2007).
