Composite Graft Pretreatment With Hydrogen Sulfide Delays the Onset of Acute Rejection
| Autor: | Jerry R. Spencer, C. Anton Fries, Rory F. Rickard, Lin C. Wang, Mark B. Roth, Vijay S. Gorantla, Sharon D. Lawson, Michael R. Davis |
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| Rok vydání: | 2019 |
| Předmět: |
Graft Rejection
medicine.medical_specialty Swine medicine.medical_treatment Ischemia 030230 surgery Risk Assessment Vascularized Composite Allotransplantation Random Allocation 03 medical and health sciences 0302 clinical medicine Preoperative Care medicine Animals Hydrogen Sulfide Wound Healing business.industry Graft Survival medicine.disease Myocutaneous Flap Autotransplantation Surgery Transplantation Disease Models Animal Treatment Outcome 030220 oncology & carcinogenesis Acute Disease Multivariate Analysis Toxicity Composite graft Composite Tissue Allografts Solid organ transplantation business Reperfusion injury |
| Zdroj: | Annals of Plastic Surgery. 82:452-458 |
| ISSN: | 1536-3708 0148-7043 |
| DOI: | 10.1097/sap.0000000000001693 |
| Popis: | INTRODUCTION Vascularized composite allotransplantation can reconstruct devastating tissue loss by replacing like-with-like tissues, most commonly in the form of hand or face transplantation. Unresolved technical and ethical challenges have meant that such transplants remain experimental treatments. The most significant barrier to expansion of this field is the requirement for systemic immunosuppression, its toxicity and effect on longevity.Hydrogen sulfide (H2S) has been shown experimentally to ameliorate the ischemia reperfusion injury associated with composite tissue autotransplantation, which has been linked to acute rejection in solid organ transplantation. In this protocol, a large-animal model was used to evaluate the effect of H2S on acute rejection after composite tissue allotransplantation. MATERIALS AND METHODS A musculocutaneous flap model in SLA-mismatched swine was used to evaluate acute rejection of allotransplants in 2 groups: control animals (n = 8) and a treatment group in which the allografts were pretreated with hydrogen sulfide (n = 8). Neither group was treated with systemic immunosuppression. Acute rejection was graded clinically and histopathologically by an independent, blinded pathologist. Data were analyzed by t tests with correction for multiple comparisons by the Holm-Sidak method. RESULTS Clinically, H2S-treated tissue composites showed a delay in the onset of rejection that was statistically significant from postoperative day 6. Histopathologically, this difference between groups was also apparent, although evidence of a difference in groups disappeared beyond day 10. CONCLUSIONS Targeted hydrogen sulfide treatment of vascularized composite allografts immediately before transplantation can delay acute rejection. This may, in turn, reduce or obviate the requirement for systemic immunosuppression. |
| Databáze: | OpenAIRE |
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