Donor to recipient ratios in the surgical treatment of vitiligo and piebaldism: a systematic review.

Autor: Narayan VS; Department of Dermatology, Amsterdam University Medical Center, Netherlands Institute for Pigment Disorders, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands., van den Bol LLC; Department of Dermatology, Amsterdam University Medical Center, Netherlands Institute for Pigment Disorders, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands., van Geel N; Department of Dermatology, Ghent University Hospital, Ghent, Belgium., Bekkenk MW; Department of Dermatology, Amsterdam University Medical Center, Netherlands Institute for Pigment Disorders, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands., Luiten RM; Department of Dermatology, Amsterdam University Medical Center, Netherlands Institute for Pigment Disorders, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands., Wolkerstorfer A; Department of Dermatology, Amsterdam University Medical Center, Netherlands Institute for Pigment Disorders, Amsterdam Infection and Immunity Institute, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of the European Academy of Dermatology and Venereology : JEADV [J Eur Acad Dermatol Venereol] 2021 May; Vol. 35 (5), pp. 1077-1086. Date of Electronic Publication: 2021 Feb 12.
DOI: 10.1111/jdv.17108
Abstrakt: Stabilized vitiligo resistant to conventional therapy (e.g. segmental vitiligo) and piebaldism lesions can be treated with autologous cellular grafting techniques, such as non-cultured cell suspension transplantation (NCST) and cultured melanocyte transplantation (CMT). These methods are preferred when treating larger surface areas due to the small amount of donor skin needed. However, the donor to recipient expansion ratios and outcomes reported in studies with cellular grafting vary widely, and to date, no overview or guideline exists on the optimal ratio. The aim of our study was to obtain an overview of the various expansion ratios used in cellular grafting and to identify whether expansion ratios affect repigmentation and colour match. We performed a systematic literature search in MEDLINE and EMBASE to review clinical studies that reported the expansion ratio and repigmentation after cellular grafting. We included 31 eligible clinical studies with 1591 patients in total. Our study provides an overview of various expansion ratios used in cellular grafting for vitiligo and piebaldism, which varied from 1:1 up to 1:100. We found expansion ratios between 1:1 and 1:10 for studies investigating NCST and from 1:20 to 1:100 in studies evaluating CMT. Pooled analyses of studies with the same expansion ratio and repigmentation thresholds showed that when using the lowest (1:3) expansion ratio, the proportion of lesions achieving >50% or >75% repigmentation after NCST was significantly better than when using the highest (1:10) expansion ratio (χ 2 P = 0.000 and χ 2 P = 0.006, respectively). Less than half of our included studies stated the colour match between different expansion ratios, and results were variable. In conclusion, the results of our study indicate that higher expansion ratios lead to lower repigmentation percentages after NCST treatment. This should be taken into consideration while determining which expansion ratio to use for treating a patient.
(© 2021 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
Databáze: MEDLINE
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