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Development of a Reliable Model of Total Abdominal Wall Transplantation
Meghan A. Quigley, BS, Derek R. Fletcher, MD, Wensheng Zhang, MD, Vu T. Nguyen, MD
University of Pittsburgh
2012-01-31
Presenter: Meghan Quigley
Affidavit:
Director Name: Dr. Joseph Losee
Author Category: Student
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
How does this presentation meet the established conference educational objectives?
This presentation will address new basic science research in the area of composite tissue allotransplantation.
How will your presentation be used by practicing physicians in the audience?
Practicing physicians will gain insight into the advances being made in composite tissue allotransplantation research that will hopefully be translated to the clinical arena in the future.
Background: One of the most common complications associated with abdominal solid organ transplantation are issues with the abdominal wall closure. This difficulty, along with the recent rise in the use of CTA, has led surgeons to the notion of abdominal wall transplantation.
Methods: We have developed a novel and reliable surgical model for a full-thickness total abdominal wall transplant based on a unilateral pedicle between fully MHC-mismatched rat strains. We utilize an established cuff technique to anastomose the donor's common iliac vessels to the recipient's femoral vessels. Three groups of animals (n=6) received FK506 monotherapy–0.25, 0.50, or 0.75 mg/kg/d. The transplants were assessed daily for evidence of rejection by visual inspection. On POD 14, 50, 100 or at signs of acute rejection, skin biopsies were taken for H&E analysis. Assessment of donor-specific chimerism in the peripheral blood of the recipients via FACS was performed.
Results: No signs of rejection were observed in the animals receiving 0.50 or 0.75 mg/kg/d FK506. Those receiving 0.25 mg/kg/d, however, displayed a mixed rejection response. FACS analysis did not show evidence of donor-specific chimerism.
Conclusion: A full-thickness abdominal wall graft based on a unilateral pedicle is a technically feasible and reliable small animal surgical model. The use of ≥0.50 mg/kg/d FK506 results in 100% graft survival. FACS analysis shows that this acceptance cannot be attributed to the presence of donor-specific chimerism. Future plans are to utilize this model to investigate the immunologic interaction of a concomitant solid organ and an abdominal wall allograft.
