A study of the fate of nerve homografts in man

Barnes, R. F. W.; Bacsich, Paul; Wyburn, G. M.; Kerr, a

doi:10.1002/bjs.18003413306

Cited by 28 publications

(7 citation statements)

References 7 publications

(9 reference statements)

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“…During the same period histological evidence of regeneration through grafts in a limb was provided by Seddon, Young, and Holmes (1942), and by Barnes, Bacsich, and Wyburn (1945).…”

Section: A Case Of Spontaneous Curementioning

confidence: 77%

“…The final results in these cases were not altogether encouraging, and it is possible that longstanding degeneration of a graft is positively harmful, on account of the considerable shrinkage of the Schwann tubes (Holmes and Young, 1942;Sanders and Young, 1944) having prevented the outgrowing nerve-fibres from attaining diameters adequate for satisfactory function. In the case described by Barnes et al (1945) the graft taken from the peripheral stump of the ulnar nerve 613 days after injury was found to contain only very small fibres, all unmedullated. The poor condition of the fibres was ascribed to the extensive intrafascicular collagenization.…”

Section: I54mentioning

confidence: 92%

“…An objection to the use of main-trunk grafts is the risk of more or less necrosis j it has certainly been reported (Sanders, IgqZ), and was observed in one of our cases (Table VI, Case A.35;Holmes, 1947). Yet histological observations made by Barnes et al (1945) and Holmes (1947) show that a large graft may survive. There may well be a critical diameter which it is unwise to exceed, and it is possible that the size of the lateral popliteal nerve, the largest we have employed apart from the one main sciatic graft, exceeds the limit of safety.…”

Section: I54mentioning

confidence: 98%

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The use of autogenous grafts for the repair of large gaps in peripheral nerves

Seddon

1947

Journal of British Surgery

184

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“…During the same period histological evidence of regeneration through grafts in a limb was provided by Seddon, Young, and Holmes (1942), and by Barnes, Bacsich, and Wyburn (1945).…”

Section: A Case Of Spontaneous Curementioning

confidence: 77%

Section: I54mentioning

confidence: 92%

Section: I54mentioning

confidence: 98%

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The use of autogenous grafts for the repair of large gaps in peripheral nerves

Seddon

1947

Journal of British Surgery

184

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“…However, the problem of active acquired immunity (rejection) developing towards an implant remains unsolved. A homograft provokes a brisk cellular and humoral reaction (Sanders and Young 1942) and this causes complete failure of a homograft in man (Seddon and Holmes 1944;Spurling et al 1945;Barnes et al 1946). Thus, it becomes a race between the growth of axons through the graft and development of rejection in the host.…”

Section: Historymentioning

confidence: 97%

Homologous nerve transplantation and immunosuppression in rabbits

Parekh

1981

Res. Exp. Med.

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Homologous nerve transplantation is a logical method of bridging major nerve defects but its usefulness is negated by immune rejection. The discovery of an effective method of immunosuppression would allow utilisation of this technique. The present study compared the effects of irradiation, dexamethasone, and chloramphenicol in homologous nerve transplantation. Segments of homologous sciatic nerve were implanted into the dorsal subcutaneous (s.c.) tissues of 83 rabbits. In one group the graft was irradiated in vitro before implantation and in other groups the recipient rabbits received either dexamethasone or chloramphenicol systemically for up to 3 weeks after implantation. The transplanted nerve segments were removed at different time intervals and examined for signs of rejection. In conclusion, rejection commenced during the 1st week and peaked during the 3rd week. In the control group without immunosuppressant, all animals exhibited severe rejection. Both pre-implantation irradiation of the grafts at 450 rad dose-level and systemic chloramphenicol at 100 mg/kg/day were found to completely suppress rejection. These methods were considerably more effective than conventional steroids. Thus, the idea of a "nerve bank" is postulated.

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“…17 " 9 The clinical use of PNA has been condemned by some, 10 especially after a spurious report of successful functional recovery. 3 Three basic approaches to improving success with peripheral-nerve allografts have been suggested: (1) reducing the mismatch at the major histocompatibility complex to minimize antigen disparity 1112 ;…”

mentioning

confidence: 99%

Peripheral-Nerve Allotransplantation in Rats Immunosuppressed with Transient or Long-Term FK-506

Weinzweig¹,

Grindel²,

Gonzalez³

et al. 1996

J reconstr Microsurg

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The purpose of this study was to assess regeneration across peripheral-nerve allografts by electro-physiologic methods, in rats receiving transient or long-term immunosuppression with FK-506. Lewis rats (LEW, RT1(1)) were recipients of sciatic nerve isografts or allografts from donor LEW or ACI (RT1a) rats, respectively. This latter donor-recipient inbred combination represents a major histoincompatible mismatch. The sciatic nerve was exposed through a gluteal muscle-splitting incision. A 2.0-cm segment of nerve was excised and a 2.5-cm graft sutured into the gap in epineural fashion. Seven groups (n = 8 each) included: Group 1--isograft control (LEW/LEW): Group 2--allograft control (LEW/ACI); Group 3--allografts receiving cyclosporin A (CsA) (10 mg/kg BW/day) subcutaneously for 2 weeks; Group 4--CsA for 2 weeks then biweekly subcutaneously; Group 5--FK-506 (10 mg/kg BW) intramuscularly by single injection; Group 6--FK-506 (1.0 mg/kg BW/day) for 2 weeks then biweekly intramuscularly; and Group 7--FK-506 for 2 weeks then biweekly intramuscularly. At 7 months, conduction velocities were determined and statistical analysis was performed. Excellent neural regeneration was observed in the isograft group (61.6 m/s), the allograft groups receiving long-term immunosuppression with either CsA (62.3 m/s) or FK-506 (61.7 m/s), and the transient FK-506 group (60.2 m/s). The transient CsA group (41.9 m/s), the allograft control group (53.4 m/s), and the single-dose FK-506 group (40.8 m/s) demonstrated significantly poorer results. Transient immunosuppression with FK-506 allowed for the restoration of anatomic and physiologic function of a peripheral-nerve allograft in inbred rats.

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A study of the fate of nerve homografts in man

Cited by 28 publications

References 7 publications

The use of autogenous grafts for the repair of large gaps in peripheral nerves

The use of autogenous grafts for the repair of large gaps in peripheral nerves

Homologous nerve transplantation and immunosuppression in rabbits

Peripheral-Nerve Allotransplantation in Rats Immunosuppressed with Transient or Long-Term FK-506

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