Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model

Background:. Representative translational animal models play a key role in vascularized composite allotransplantation (VCA) research. A composite porcine hindlimb flap, previously described, is a relevant preclinical model. However, its bulkiness and the absence of critical immunologic tissues make...

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Main Authors: Stefanie Hirsiger, MD, Ioana Lese, MD, Isabel Arenas Hoyos, MD, Cédric Zubler, MD, David Haberthür, PhD, Ruslan Hlushchuk, MD, Valentin Djonov, MD, Yara Banz, MD, PhD, Ana Macek, MD, Hendrik von Tengg-Kobligk, MD, Daniela Casoni, VMD, PhD, Robert Rieben, PhD, Radu Olariu, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2024-11-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006296
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author Stefanie Hirsiger, MD
Ioana Lese, MD
Isabel Arenas Hoyos, MD
Cédric Zubler, MD
David Haberthür, PhD
Ruslan Hlushchuk, MD
Valentin Djonov, MD
Yara Banz, MD, PhD
Ana Macek, MD
Hendrik von Tengg-Kobligk, MD
Daniela Casoni, VMD, PhD
Robert Rieben, PhD
Radu Olariu, MD, PhD
author_facet Stefanie Hirsiger, MD
Ioana Lese, MD
Isabel Arenas Hoyos, MD
Cédric Zubler, MD
David Haberthür, PhD
Ruslan Hlushchuk, MD
Valentin Djonov, MD
Yara Banz, MD, PhD
Ana Macek, MD
Hendrik von Tengg-Kobligk, MD
Daniela Casoni, VMD, PhD
Robert Rieben, PhD
Radu Olariu, MD, PhD
author_sort Stefanie Hirsiger, MD
collection DOAJ
description Background:. Representative translational animal models play a key role in vascularized composite allotransplantation (VCA) research. A composite porcine hindlimb flap, previously described, is a relevant preclinical model. However, its bulkiness and the absence of critical immunologic tissues make it less suitable for investigating the unique immunologic features of VCA. We aimed to further develop this model by reducing its bulkiness and by including donor-draining lymph nodes. Methods:. We conducted an anatomic study by harvesting 11 porcine osteomyocutaneous flaps (4 conventional and 7 modified techniques), which were characterized by computed tomography. Furthermore, 8 allotransplantations were performed in Swiss landrace pigs. After the procedure, animals were assigned to a model development and control group (N = 4 per group). No immunosuppression was given, and animals were followed up until grade 3 rejection. Results:. With the modified technique, the flap weight was significantly reduced with a mean weight of 831 g, corresponding to 1.8% total body weight versus 1710 g in the conventional technique, representing 4.2% of total body weight (P < 0.0001). The muscle/bone ratio was reduced from 8.24 (conventional) to 2.92 (modified), (P = 0.03). Histologically, graft-draining lymph nodes showed typical changes related to rejection and no signs of ischemia after in vivo transplantation. Conclusions:. By modifying the surgical technique, the bulkiness of the flap was markedly reduced, without impairing its vascularization and reliably including vascularized graft-draining lymph nodes. Our modified VCA model in the pig presents distinct advantages for surgery as well as immunologic analysis, warranting a large-scale use for experimental reconstructive transplantation studies.
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spelling doaj-art-4993c2bdbddf41c295e145b651774b942024-11-26T08:02:35ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-11-011211e629610.1097/GOX.0000000000006296202411000-00025Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig ModelStefanie Hirsiger, MD0Ioana Lese, MD1Isabel Arenas Hoyos, MD2Cédric Zubler, MD3David Haberthür, PhD4Ruslan Hlushchuk, MD5Valentin Djonov, MD6Yara Banz, MD, PhD7Ana Macek, MD8Hendrik von Tengg-Kobligk, MD9Daniela Casoni, VMD, PhD10Robert Rieben, PhD11Radu Olariu, MD, PhD12From the * Department of Plastic and Hand Surgery, Inselspital University Hospital, University of Bern, Bern, SwitzerlandFrom the * Department of Plastic and Hand Surgery, Inselspital University Hospital, University of Bern, Bern, SwitzerlandFrom the * Department of Plastic and Hand Surgery, Inselspital University Hospital, University of Bern, Bern, Switzerland‡ Institute of Anatomy, University of Bern, Bern, Switzerland‡ Institute of Anatomy, University of Bern, Bern, Switzerland‡ Institute of Anatomy, University of Bern, Bern, Switzerland‡ Institute of Anatomy, University of Bern, Bern, Switzerland§ Institute of Pathology, University of Bern, Bern, Switzerland¶ Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital University Hospital, University of Bern, Bern, Switzerland.¶ Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital University Hospital, University of Bern, Bern, Switzerland.† Department for BioMedical Research, University of Bern, Bern, Switzerland† Department for BioMedical Research, University of Bern, Bern, SwitzerlandFrom the * Department of Plastic and Hand Surgery, Inselspital University Hospital, University of Bern, Bern, SwitzerlandBackground:. Representative translational animal models play a key role in vascularized composite allotransplantation (VCA) research. A composite porcine hindlimb flap, previously described, is a relevant preclinical model. However, its bulkiness and the absence of critical immunologic tissues make it less suitable for investigating the unique immunologic features of VCA. We aimed to further develop this model by reducing its bulkiness and by including donor-draining lymph nodes. Methods:. We conducted an anatomic study by harvesting 11 porcine osteomyocutaneous flaps (4 conventional and 7 modified techniques), which were characterized by computed tomography. Furthermore, 8 allotransplantations were performed in Swiss landrace pigs. After the procedure, animals were assigned to a model development and control group (N = 4 per group). No immunosuppression was given, and animals were followed up until grade 3 rejection. Results:. With the modified technique, the flap weight was significantly reduced with a mean weight of 831 g, corresponding to 1.8% total body weight versus 1710 g in the conventional technique, representing 4.2% of total body weight (P < 0.0001). The muscle/bone ratio was reduced from 8.24 (conventional) to 2.92 (modified), (P = 0.03). Histologically, graft-draining lymph nodes showed typical changes related to rejection and no signs of ischemia after in vivo transplantation. Conclusions:. By modifying the surgical technique, the bulkiness of the flap was markedly reduced, without impairing its vascularization and reliably including vascularized graft-draining lymph nodes. Our modified VCA model in the pig presents distinct advantages for surgery as well as immunologic analysis, warranting a large-scale use for experimental reconstructive transplantation studies.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006296
spellingShingle Stefanie Hirsiger, MD
Ioana Lese, MD
Isabel Arenas Hoyos, MD
Cédric Zubler, MD
David Haberthür, PhD
Ruslan Hlushchuk, MD
Valentin Djonov, MD
Yara Banz, MD, PhD
Ana Macek, MD
Hendrik von Tengg-Kobligk, MD
Daniela Casoni, VMD, PhD
Robert Rieben, PhD
Radu Olariu, MD, PhD
Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model
Plastic and Reconstructive Surgery, Global Open
title Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model
title_full Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model
title_fullStr Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model
title_full_unstemmed Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model
title_short Lymph Node Inclusion in a Modified Osteomyocutaneous Allograft for Vascularized Composite Allotransplantation: Establishment and Feasibility Assessment in a Pig Model
title_sort lymph node inclusion in a modified osteomyocutaneous allograft for vascularized composite allotransplantation establishment and feasibility assessment in a pig model
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006296
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