title: Cadaveric nerve allotransplantation in the treatment of persistent thoracic neuralgia.
abstract: When relief from neuralgia cannot be achieved with traditional methods, neurectomy may be considered to abate the stimulus, and primary opposition of the terminal nerve ending is recommended to prevent neuroma. Nerve repair with autograft is limited by autologous nerves available for large nerve defects. Cadaveric allografts provide an unlimited graft source without donor-site morbidities, but are rapidly rejected unless appropriate immunosuppression is achieved. An optimal treatment method for nerve allograft transplantation would minimize rejection while simultaneously permitting nerve regeneration. This report details a novel experience of nerve allograft transplantation using cadaveric nerve grafts to desensitize persistent postoperative thoracic neuralgia.
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, Washington, DC.
authors.forename: John R
authors.initials: JR
authors.lastname: Barbour
authors.affiliation: Division of Plastic Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Andrew
authors.initials: A
authors.lastname: Yee
authors.affiliation: Division of Plastic Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Moore
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Elbert P
authors.initials: EP
authors.lastname: Trulock
authors.affiliation: Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Buchowski
authors.affiliation: Division of Plastic Surgery, Washington University School of Medicine, St. Louis, Missouri. Electronic address: mackinnon@wudosis.wustl.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Mackinnon
mesh_terms: D002102:Cadaver; D006085:Graft Survival; D006801:Humans; D007367:Intercostal Nerves / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods*; D009437:Neuralgia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D010147:Pain Measurement; D010148:Intractable Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D010149:Postoperative Pain / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome