title: Clinical strategies to enhance nerve regeneration in composite tissue allotransplantation.
abstract: Reinnervation of a hand transplant ultimately dictates functional recovery but provides a significant regenerative challenge. This article highlights interventions to enhance nerve regeneration through acceleration of axonal regeneration or augmentation of Schwann cell support and discuss their relevance to composite tissue allotransplantation. Surgical techniques that may be performed at the time of transplantation to optimize intrinsic muscle recovery--including appropriate alignment of ulnar nerve motor and sensory components, transfer of the distal anterior interosseous nerve to the recurrent motor branch of the median nerve, and prophylactic release of potential nerve entrapment points--are also presented.
authors: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA.
authors: Simone W
authors: SW
authors: Glaus
authors: Philip J
authors: PJ
authors: Johnson
authors: Susan E
authors: SE
authors: Mackinnon
mesh_terms: D000818:Animals; D001369:Axons / Q000502:physiology; D002454:Cell Differentiation / Q000502:physiology; D063987:Hand Transplantation; D006801:Humans; D018482:Muscle, Skeletal / Q000294:innervation; D009416:Nerve Regeneration / Q000502:physiology*; D059348:Peripheral Nerve Injuries / Q000503:physiopathology / Q000601:surgery*; D012583:Schwann Cells / Q000502:physiology / Q000637:transplantation; D016559:Tacrolimus / Q000627:therapeutic use; D014184:Transplantation, Homologous; D014459:Ulnar Nerve / Q000502:physiology; D014855:Wallerian Degeneration / Q000503:physiopathology
chemical_list: D016559:Tacrolimus