Shigetomi M, Doi K, Kuwata N, Muramatsu K, Yamamoto H, Kawai S
Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Japan.
Microsurgery. 1994;15(9):663-70. doi: 10.1002/micr.1920150913.
To study the healing mechanism of vascularized bone allografts under short-term as well as long-term immunosuppression with cyclosporin A, experimental vascularized intercalary bone allograft transplantation was carried out between inbred rats using the tibiofibula graft model. Bone scintigram and radiographs were used as an indicator for early detection of rejection after transplantation and bone union. In vascularized bone allografts under long-term immunosuppression with cyclosporin A, early bone union and continuous incorporation were similar to that observed in vascularized bone autograft transplantation. When administration of cyclosporin A was discontinued before completion of bone union, the graft was rejected and bone union was delayed. Apparent swelling on the operated limb associated with a decrease in bone scintigram uptake suggested the occurrence of rejection of the allograft. Vascularized bone allograft transplantation is useful for reconstruction of massive bone defects only if immunosuppressants are used and maintained at least until bone union is obtained.
为了研究使用环孢素A进行短期和长期免疫抑制情况下血管化同种异体骨移植的愈合机制，利用胫腓骨移植模型在近交系大鼠之间进行了实验性血管化节段性骨移植。骨闪烁显像和X线片用作移植后排斥反应及骨愈合早期检测的指标。在使用环孢素A进行长期免疫抑制的血管化同种异体骨移植中，早期骨愈合和持续融合与血管化自体骨移植中观察到的情况相似。当在骨愈合完成前停用环孢素A时，移植物被排斥，骨愈合延迟。手术肢体明显肿胀并伴有骨闪烁显像摄取减少提示同种异体移植物发生了排斥反应。只有使用免疫抑制剂并至少维持至获得骨愈合时，血管化同种异体骨移植才有助于重建大块骨缺损。
