Clinical Research Division Fred Hutchinson, Cancer Research Center, University of Washington School of Medicine, Seattle, Washington, USA.
J Reconstr Microsurg. 2010 Apr;26(3):201-7. doi: 10.1055/s-0030-1247717. Epub 2010 Jan 27.
The feasibility of composite tissue allografts (CTAs) has been demonstrated by the successful transplantation of the hand, abdomen, and face. However, the survival of these transplants depends on immunosuppression. Our laboratory is interested in achieving tolerance to decrease the risks associated with the use of chronic immunosuppression. The purpose of this experiment was to develop a large-animal model for CTA. Four canine flaps were autotransplanted to examine the use of a myocutaneous rectus flap based on the deep inferior epigastric vessels. Five CTA transplants were performed between dog leukocyte antigen (DLA)-identical littermates without posttransplant immunosuppression. The allografts were followed clinically and underwent routine biopsies. The anatomic dissections and autotransplants were all successful and revealed that the flap could be divided into two separate components. Skin was perfused by the superficial epigastric artery. Rectus muscle was perfused by the deep inferior epigastric system. This allowed the allografts to be transplanted as muscle or skin or with both components based on the external iliac artery and veins. The DLA-identical littermates rejected the allografts in 15 to 30 days. This study demonstrated the versatility of the myocutaneous rectus flap for use in canines as CTA models.
复合组织同种异体移植物(CTAs)的可行性已通过手部、腹部和面部的成功移植得到证明。然而,这些移植物的存活依赖于免疫抑制。我们的实验室有兴趣实现对移植物的免疫耐受,以降低使用慢性免疫抑制相关的风险。本实验的目的是开发一种用于 CTA 的大动物模型。将四个犬皮瓣自体移植,以检查基于腹壁下深血管的肌皮腹直肌瓣的应用。在没有移植后免疫抑制的情况下,在犬白细胞抗原(DLA)相同的同窝仔犬之间进行了五次 CTA 移植。对同种异体移植物进行了临床随访,并进行了常规活检。解剖和自体移植均成功,表明该皮瓣可分为两个独立的部分。皮肤由腹壁浅动脉灌注。腹直肌由腹壁下深系统灌注。这使得同种异体移植物可以根据髂外动脉和静脉移植为肌肉或皮肤,或移植为两者的组合。DLA 相同的同窝仔犬在 15 至 30 天内排斥了同种异体移植物。本研究证明了肌皮腹直肌瓣在犬类 CTA 模型中的多功能性。