Get access

Evaluation of a porcine whole-limb heterotopic autotransplantation model

Authors

  • David Manuel Kiermeir M.D.,

    Corresponding author
    1. Department of Plastic and Hand Surgery, Bern University Hospital, Bern, Switzerland
    2. Department of Clinical Research, University of Bern, Bern, Switzerland
    • Department of Plastic and Hand Surgery, University Hospital Inselspital, Freiburgstrasse, CH-3010 Bern, Switzerland
    Search for more papers by this author
  • Martino Meoli M.D.,

    1. Department of Plastic and Hand Surgery, Bern University Hospital, Bern, Switzerland
    2. Department of Clinical Research, University of Bern, Bern, Switzerland
    Search for more papers by this author
  • Sabine Müller M.D.,

    1. Department of Clinical Research, University of Bern, Bern, Switzerland
    Search for more papers by this author
  • Susanne Abderhalden M.D.,

    1. Department of Radiology, Stadtspital Triemli, Zürich, Switzerland
    Search for more papers by this author
  • Esther Vögelin M.D.,

    1. Department of Plastic and Hand Surgery, Bern University Hospital, Bern, Switzerland
    2. Department of Clinical Research, University of Bern, Bern, Switzerland
    Search for more papers by this author
  • Mihai Adrian Constantinescu M.D.

    1. Department of Plastic and Hand Surgery, Bern University Hospital, Bern, Switzerland
    2. Department of Clinical Research, University of Bern, Bern, Switzerland
    Search for more papers by this author

Abstract

Background:

Recently performed vascularized composite tissue allotransplantations (CTAs) stimulate the ongoing research in the area of whole-limb transplantation. A reliable in vivo animal model is required for investigations in vascularized whole-limb CTA. The model should allow in vivo assessment in whole-limb preservation, allograft and xenograft response, and host immunomodulation. The goal of this study is to describe and evaluate the in vivo feasibility and reproducibility of a whole-limb porcine model as a basis for future research in this field.

Materials and methods:

In seven large white pigs, one forelimb was amputated under anesthesia and autotransplanted heterotopically with an arc of rotation of 180° and partially placed in a subcutaneous pocket. Clinical parameters were monitored and muscle biopsies were analyzed using ultrastructural morphological assessment of mitochondria quality after an observation period of 7 days.

Results:

All animals could fully mobilize postoperatively without restrictions. At sacrifice, the anastomosed pedicle vessels of the limb were patent in six animals. In one pig, venous thrombosis could be observed. Muscle response was triggered following direct electrostimulation in six replanted limbs. The replanted extremities gained 12.97% weight within 7 days postreplantation compared with the amputation baseline values (P = 0.464 while maintaining normal compartment pressures at sacrifice (8.25 ± 5.31 cmH2O, P = 0.60). The ultrastructural evaluation of mitochondria morphology revealed intact mitochondria without signs of ischemia/reperfusion damage.

Conclusion:

This porcine model proved feasible, reliable, and reproducible for whole-limb autotransplantation. It presents significant potential in future preclinical research of whole-limb CTA transplantation. © 2012 Wiley Periodicals, Inc., Microsurgery, 2013.

Ancillary