Autogenous Venous Graft with One-Stage Prepared Schwann Cells as a Conduit for Repair of Long Segmental Nerve Defects

Abstract

The use of autogenous venous graft with intraluminal injection of Schwann cells to enhance nerve regeneration of long segmental nerve defects was evaluated in a rabbit tibial nerve-repair model. Schwann cells were isolated from the excised rabbit tibial nerve by using the polylysine differential adhesion method. The cultured cells were identified by immunocytochemical labeling for S-100 protein. Tibial nerve defects in 4-cm segments were created in 24 animals, which were then divided into three groups. In Group 1, the tibial nerve defect was repaired with interposition vein graft alone; in Group 2, the nerve defect was repaired with a vein graft with intraluminal injection of Schwann-cell suspension; in Group 3, the nerve defect was repaired by autogenous nerve graft alone. At 2 months postoperatively, electrophysiologic evaluation showed that an evoked muscle action potential was recorded for the animals in Group 2, with vein grafting plus Schwann cells, and for those in Group 3, with autogenous nerve grafting, but not for those in Group 1, where vein grafting alone was used. The average motor nerve conduction velocity in the group with vein grafting and Schwann cells was 3.4 +/- 1.5 m/sec, which was slower than the nerve grafting group (7.8 +/- 1.8 m/sec). Histologic analysis confirmed there was formation of new nerve fascicles with myelination in the vein graft filled with Schwann cells. No nerve regrowth was found in the vein grafts without Schwann cells. These results suggested that isolated Schwann cells are able to survive in a vein graft, and that the vein graft with intraluminal seeded Schwann cells could be an alternative for repairing injured nerves with long gaps.

A Biological Tube Technique For The Repair Of Peripheral Nerve Defects Using ‘Stuffed Nerves’

“…Subsequent comparisons revealed superior axon regeneration in veins with transplanted Schwann cells. [29] However, Schwann cells are difficult to isolate and are expensive, making the use of minced nerve parts as shown in the present study a practical option.…”

First human experience with autologous Schwann cells to supplement sciatic nerve repair: report of 2 cases with long-term follow-up

“…Although initial reports focused on short gap repairs, 5,18,26 several substrates have been studied for their potential to heal large gap defects when supplemented with AGCs, including purified SCs. 1,6,7,9,11,12,16,17,27,28,34,37,38,[40][41][42]44 Berrocal et al demonstrated that adding autologous SCs suspended in serum to AGCs significantly enhanced the ability to bridge larger gap distances in sciatic nerve repair in rats. 3 Autologous SCs can be harvested from either a donor nerve or from the epicenter of the traumatized nerve ends in sharp injuries (propeller injury, gunshot wound, stab wound).…”

Perspectives in regeneration and tissue engineering of peripheral nerves

“…Hadlock et al (2000) and Mosahebi et al (2001) showed, in the rat, that SC transplantation inside different types of nerve conduit leads to the improvement of both quality and rate of axon regeneration. SC-seeded vein conduits proved also to be effective, in the rabbit, in bridging long nerve defects up to 4 cm (Zhang et al, 2002) and 6 cm (Strauch et al, 2001), whereas the use of the vein conduit alone in the same experimental conditions was ineffective.…”