Background: Composite tissue allograft transplantation provides a better reconstructive option for patients who suffer from extensive craniomaxillofacial deformities. However, there is a lack of sufficient experimental data including anatomical and immunologic aspects in larger animals. The purpose of this study was to develop a new orthotopic composite hemiface/calvaria transplantation model in rabbits with which to estimate the feasibility of composite tissue allografts.
Methods: A total of 36 rabbits were studied. The anatomical features were explored in six rabbits. Group I (n = 6) represented the autograft group. In the allograft control group (group II, n = 12) and the treatment group (group III, n = 12), orthotopic composite hemiface/calvaria allotransplantations were performed from Dutch to Japanese White rabbits. Recipients in the treatment group received low-dose cyclosporine A/prednisone combination therapy. Evaluation methods included clinical inspection, histologic analysis, immunohistochemistry, and radiography.
Results: The animals in the autograft group survived indefinitely. Four of six nontreated allografts were rejected within 7 to 10 days. In the treatment group, five of six recipients showed no signs of rejection up to the endpoint of the study. Only one recipient died as a result of anorexia, on day 18. The histologic outcomes were well correlated with clinical inspection. Bone biopsy specimens at posttransplant days 7 and 120 revealed viable bone. Radiologic grade at day 120 showed no significant difference between the autograft (10.67 ± 1.03) and treatment groups (9.2 ± 1.30).
Conclusions: Low-dose cyclosporine A/prednisone combination therapy does not influence bone viability and healing. A new orthotopic hemiface/calvaria allotransplantation model was established successfully that allows further studies on reconstruction of extensive craniomaxillofacial defects.
Harbin, People’s Republic of China
From the Department of Plastic Surgery, the Second Hospital of Harbin Medical University.
Received for publication October 24, 2007; accepted January 7, 2008.
Disclosure: The authors have no conflicts of interest to disclose.
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Daping Yang, M.D., Division of Plastic Surgery, Second Hospital of Harbin Medical University, Harbin, People’s Republic of China 150086, firstname.lastname@example.org