title: Swine hemi-facial composite tissue allotransplantation: a model to study immune rejection.
abstract: OBJECTIVE
  Partial face composite tissue allotransplantation was recently achieved in a human subject. However, the side effects of long-term immunosuppression and chronic rejection area still need concerning. This preliminary study investigated the reproducibility of swine hemi-facial transplantation for preclinical studies.
  
  
  METHODS
  Eleven out-bred miniature swine underwent hemi-facial transplant. The hemi-facial orthotopic transplant consisted of ear cartilage, auricular nerve, parotid gland and lymphoid tissue, muscle with surrounding hemi-facial skin paddle supplied by the carotid artery, and external jugular vein transplanted to recipient swine. Three different experimental designs were studied, as follows: group I (n = 4): autologous hemi-facial transplantation as a normal control; group II (n = 4): hemi-facial allotransplantation without treatment; group III (n = 3): hemi-facial allotransplantation with cyclosporine-A treatment for 4 wk. The transplanted face was observed daily for signs of rejection. Biopsy of donor skin, gland lymphoid tissue, and cartilage were obtained at specified predetermined time (d 7, 14, 28), or at the time of clinically evident rejection.
  
  
  RESULTS
  The results indicated the survival of group I following autologous hemi-facial transplant was 100% and indefinite until sacrifice. Group II without treatment as the controls revealed allograft rejection by d 7 to 28. The allograft with short-term cyclosporine-A treatment revealed delayed rejection by d 38 to 49 postoperatively. The histological examination in group I revealed abundant lymphocyte infiltration, especially in lymphoid gland and alloskin at 1 wk and sacrifice. In contrast, the cyclosporine treatment group showed no significant rejection signs in 4 wk posttransplants. These results demonstrated that lymphoid tissue and alloskin are both susceptible to early rejection.
  
  
  CONCLUSIONS
  The experimental results revealed this model is suitable to investigate the new strategies for preclinical facial allotransplantation studies. Monitoring and modulation of early rejection in alloskin and gland lymphoid tissue is a useful strategy to evaluate composite tissue allotransplantation survival.
authors: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.
authors: Yur-Ren
authors: YR
authors: Kuo
authors: Hsiang-Shun
authors: HS
authors: Shih
authors: Chien-Chih
authors: CC
authors: Lin
authors: Chung-Cheng
authors: CC
authors: Huang
authors: Johnson Chia-Shen
authors: JC
authors: Yang
authors: Wen-Sheng
authors: WS
authors: Wu
authors: Shigeru
authors: S
authors: Goto
authors: Chao-Long
authors: CL
authors: Chen
authors: W P Andrew
authors: WP
authors: Lee
mesh_terms: D000818:Animals; D016572:Cyclosporine / Q000494:pharmacology / Q000627:therapeutic use; D004195:Disease Models, Animal; D005145:Face / Q000473:pathology / Q000601:surgery; D054445:Facial Transplantation; D006084:Graft Rejection / Q000473:pathology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D013552:Swine; D013556:Swine, Miniature; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine