title: A novel rat full-thickness hemi-abdominal wall/hindlimb osteomyocutaneous combined flap: influence of allograft mass and vascularized bone marrow content on vascularized composite allograft survival.
abstract: Vascularized bone marrow transplantation (VBMT) appears to promote tolerance for vascularized composite allotransplantation (VCA). However, it is unclear whether VBMT is critical for tolerance induction and, if so, whether there is a finite amount of VCA that VBMT can support. We investigated this with a novel VCA combined flap model incorporating full-thickness hemiabdominal wall and hindlimb osteomyocutaneous (HAW/HLOMC) flaps. Effects of allograft mass (AM) and VBMT on VCA outcome were studied by comparing HAW/HLOMC VCAs with fully MHC-mismatched BN donors and Lewis recipients. Control groups did not receive treatments following transplantation. Treatment groups received a short course of cyclosporine A (CsA), antilymphocyte serum, and three doses of adipocyte-derived stem cells (POD 1, 8, and 15). The results showed that all flaps in control allogeneic groups rejected soon after VCAs. Treatment significantly prolonged allograft survival. Three of eight recipients in HLOMC treatment group had allografts survive long-term and developed donor-specific tolerance. Significantly higher peripheral chimerism was observed in HLOMC than other groups. It is concluded that the relative amount of AM to VBMT is a critical factor influencing long-term allograft survival. Accordingly, VBMT content compared with VCA mass may be an important consideration for VCA in humans.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Pontifical Catholic University of Chile, Santiago, Chile.
authors.forename: Alejandro E
authors.initials: AE
authors.lastname: Ramirez
authors.forename: Hui-Yun
authors.initials: HY
authors.lastname: Cheng
authors.forename: William W
authors.initials: WW
authors.lastname: Lao
authors.forename: Yen-Ling
authors.initials: YL
authors.lastname: Wang
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Wen
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Wallace
authors.forename: Chih-Fan
authors.initials: CF
authors.lastname: Lin
authors.forename: Ling-Yi
authors.initials: LY
authors.lastname: Shih
authors.forename: Sheng-Hao
authors.initials: SH
authors.lastname: Chuang
authors.forename: Fu-Chan
authors.initials: FC
authors.lastname: Wei
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000818:Animals; D001853:Bone Marrow / Q000098:blood supply / Q000276:immunology; D016026:Bone Marrow Transplantation / Q000379:methods*; D064595:Composite Tissue Allografts; D005240:Feasibility Studies; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006614:Hindlimb / Q000601:surgery*; D007108:Immune Tolerance; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007959:Lymphocyte Culture Test, Mixed; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male; D009929:Organ Size; D051381:Rats; D011914:Rats, Inbred BN; D011917:Rats, Inbred Lew; D016038:Skin Transplantation; D013524:Surgical Flaps; D013623:Tail; D018183:Transplantation Chimera; D063986:Vascularized Composite Allotransplantation / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents
keywords: abdominal wall transplantation; allograft mass; allograft survival; combined flap; vascularized bone marrow; vascularized composite allotransplantation