Download PDF
J Reconstr Microsurg 2012; 28(01): 69-76
DOI: 10.1055/s-0031-1285822
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

An Optimized Dual-Surgeon Simultaneous Orthotopic Hind-Limb Allotransplantation Model in Rats

Justin M. Sacks
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
,
Yur-Ren Kuo
2   Baylor College of Medicine, Houston, Texas
,
Elaine K. Horibe
3   Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
,
Teresa Hautz
4   Division of Plastic Surgery, Universidad Federal de Sao Paulo, Sao Paulo, Brazil
,
Kriti Mohan
5   Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria
,
Ian L. Valerio
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
6   Department of Plastic and Reconstructive Surgery, Alter Reed National Military Center, Bethesda, Maryland
,
W.P. Andrew Lee
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

18 April 2010

11 March 2011

Publication Date:
23 August 2011 (online)

Also available at
    Permissions and Reprints

Abstract

Composite tissue allograft (CTA) transplantation is a promising treatment in reconstructive surgery for complex tissue injuries in humans. However, continued research is required to optimize the risk to benefit ratios. In this study, we describe, in detail, an optimized simultaneous dual-surgeon orthotopic hind-limb transplantation model in direct comparison to a single-surgeon model. In this study 75 hind-limb CTAs were performed, employing either a dual-surgeon model (n = 60) or a single-surgeon model (n = 15) for the transplantation of two hind-limbs. Operative times, complication rates, and costs were compared. The dual-surgeon approach showed a significant reduction of 45.4% in overall operative time (p < 0.05). Overall complication rate was 8%. The dual-surgeon model was ∼30.5% more cost-effective than the traditional single-surgeon approach. Benefits of the proposed simultaneous dual-surgeon orthotopic rat hind-limb CTA model include decreased operating times, decreased complication rates, and reduced financial costs when compared with the established single-surgeon model.

Keywords

hind-limb - allotransplantation - rat - experimental model - orthotopic
 

  • References

  • 1 Lee WPA. Composite tissue transplantation: more science and patience needed. Plast Reconstr Surg 2001; 107 (4) 1066-1070
    CrossrefPubMedSearch in Google Scholar
  • 2 Shapiro RI, Cerra FB. A model for reimplantation and transplantation of a complex organ: the rat hind limb. J Surg Res 1978; 24 (6) 501-506
    Search in Google Scholar
  • 3 Ulusal AE, Ulusal BG, Hung LM, Wei FC. Heterotopic hindlimb allotransplantation in rats: an alternative model for immunological research in composite-tissue allotransplantation. Microsurgery 2005; 25 (5) 410-414
    CrossrefPubMedSearch in Google Scholar
  • 4 Tung THH, Mohanakumar T, Mackinnon SE. A subcutaneous heterotopic limb transplantation model in the mouse for prolonged allograft survival. Microsurgery 2001; 21 (7) 298-305
    CrossrefPubMedSearch in Google Scholar
  • 5 Yeh LS, Gregory CR, Theriault BR, Hou SM, Lecouter RA. A functional model for whole limb transplantation in the rat. Plast Reconstr Surg 2000; 105 (5) 1704-1711
    CrossrefPubMedSearch in Google Scholar
  • 6 Nazzal JA, Johnson TS, Gordon CR, Randolph MA, Lee WPA. Heterotopic limb allotransplantation model to study skin rejection in the rat. Microsurgery 2004; 24 (6) 448-453
    CrossrefPubMedSearch in Google Scholar
  • 7 Dubernard JM, Owen E, Herzberg G , et al. Human hand allograft: report on first 6 months. Lancet 1999; 353 (9161) 1315-1320
    CrossrefPubMedSearch in Google Scholar
  • 8 Bos JD. The Skin Immune System: Cutaneous Immunology and Clinical Immunodermatology. 3rd ed. Boca Raton: CRC Press; 2004
    Search in Google Scholar
  • 9 Lee WPA, Yaremchuk MJ, Pan YC, Randolph MA, Tan CM, Weiland AJ. Relative antigenicity of components of a vascularized limb allograft. Plast Reconstr Surg 1991; 87 (3) 401-411
    CrossrefPubMedSearch in Google Scholar
  • 10 Mathes DW, Randolph MA, Solari MG , et al. Split tolerance to a composite tissue allograft in a swine model. Transplantation 2003; 75 (1) 25-31
    CrossrefPubMedSearch in Google Scholar