Department of Plastic and Hand Surgery, Bern University Hospital, Bern, Switzerland.
Microsurgery. 2013 Feb;33(2):141-7. doi: 10.1002/micr.22038. Epub 2012 Sep 13.
Recently performed vascularized composite tissue allotransplantations (CTAs) stimulate the ongoing research in the area of whole-limb transplantation. A reliable in vivo animal model is required for investigations in vascularized whole-limb CTA. The model should allow in vivo assessment in whole-limb preservation, allograft and xenograft response, and host immunomodulation. The goal of this study is to describe and evaluate the in vivo feasibility and reproducibility of a whole-limb porcine model as a basis for future research in this field.
In seven large white pigs, one forelimb was amputated under anesthesia and autotransplanted heterotopically with an arc of rotation of 180° and partially placed in a subcutaneous pocket. Clinical parameters were monitored and muscle biopsies were analyzed using ultrastructural morphological assessment of mitochondria quality after an observation period of 7 days.
All animals could fully mobilize postoperatively without restrictions. At sacrifice, the anastomosed pedicle vessels of the limb were patent in six animals. In one pig, venous thrombosis could be observed. Muscle response was triggered following direct electrostimulation in six replanted limbs. The replanted extremities gained 12.97% weight within 7 days postreplantation compared with the amputation baseline values (P = 0.464 while maintaining normal compartment pressures at sacrifice (8.25 ± 5.31 cmH(2)O, P = 0.60). The ultrastructural evaluation of mitochondria morphology revealed intact mitochondria without signs of ischemia/reperfusion damage.
This porcine model proved feasible, reliable, and reproducible for whole-limb autotransplantation. It presents significant potential in future preclinical research of whole-limb CTA transplantation.
最近进行的血管化复合组织同种异体移植（CTA）刺激了整个肢体移植领域的持续研究。需要一种可靠的活体动物模型来进行血管化全肢体 CTA 的研究。该模型应允许对全肢体保存、同种异体移植物和异种移植物反应以及宿主免疫调节进行体内评估。本研究的目的是描述和评估作为未来该领域研究基础的全肢体猪模型的体内可行性和可重复性。
在七头大白猪中，在麻醉下切除一只前肢，并以 180°的旋转弧度进行异位自体移植，并部分置于皮下袋中。在观察期为 7 天的情况下，监测临床参数并通过超微结构形态评估线粒体质量对肌肉活检进行分析。
所有动物术后均能完全自由活动，无限制。在处死时，六只动物的肢体吻合的蒂血管通畅。在一只猪中，观察到静脉血栓形成。在六只再植肢体中，直接电刺激后触发肌肉反应。与截肢基线值相比，再植肢体在 7 天内体重增加了 12.97%（P = 0.464），同时在处死时保持正常间隔压力（8.25 ± 5.31 cmH2O，P = 0.60）。线粒体形态的超微结构评估显示线粒体完整，没有缺血/再灌注损伤的迹象。
该猪模型被证明对于全肢体自体移植是可行的、可靠的和可重复的。它在未来的全肢体 CTA 移植的临床前研究中具有重要的潜力。
