Membrane Fusion Nerve Repair to Improve Limb Transplant Function
Abstract
Background: Limb transplantation has dramatically improved the lives of servicemen and civilians alive. Those who have had their limbs restored through this innovative surgery have seen improvement in their body image, decreased reliance on prosthetics and increased independence. The outcomes of these transplants are highly dependent on nerve regeneration. Nerve regeneration is time consuming and relies on intense rehabilitation. A new and exciting technique to connect cut nerve fibers using polyethylene glycol (PEG) can improve nerve function following transplant. Methods: Using a Lewis rat model, we studied the effect of PEG membrane fusion on the sciatic nerve in nerve repair and limb transplantation. To verify and quantify the results, nerve conduction studies, histomorphometry, retrograde cell labeling, and gait analysis were performed. Results: Improvements could be seen in nerve regeneration with nerve conduction, and histomorphometry. On analysis at 1 week and 20 weeks, the sciatic nerves treated with PEG/membrane fusion protocol had a higher count of distal axons than nerves without treatment. Functional improvements were noted in the simple repair groups but limb contractures made it impossible to measure function recovery in transplanted hind limbs. Conclusion: PEG membrane fusion nerve repair improved outcomes in nerve repair and showed promise in hind limb transplantation although the demonstration of functional recovery was hampered by limitations of the model. Another group at our institution has shown good results in an alternative model. Future work will involve translational large animal models to verify and refine the techniques prior to use in humans.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 2019
- Accession Number
- AD1109488
Entities
People
- Damon Cooney
Organizations
- Johns Hopkins University