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A New Face Subunit Transplant Model in Mice, Containing Skin, Mandible, and Oral Mucosa for Future Face Vascularized Composite Allotransplantation Studies

Gonzalez, Esteban Cardona MD1,2,3,6,7,*; Wang, Aline Yen Ling PhD3,*; Loh, Charles Yuen Yung MBBS, MSc, MRCS4,*; Chuang, Sheng-Hao MSc3; Lee, Chin-Ming MSc5; Deek, Nidal Al MD, MSc2,3; Lin, Cheng-Hung MD2,3; Wei, Fu-Chan MD2,3,6

Plastic and Reconstructive Surgery: April 11, 2019 - Volume PRS Online First - Issue - p
doi: 10.1097/PRS.0000000000005774
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Background: In immunologic research, mice have advantages over other animals, such as low costs, easy handling, suitable lifecycle, and adequate laboratory resources. However, mice vascularized composite allotransplantation (VCA) surgery is not popular, partly because of technical difficulties and high mortality rates. Our goal was to demonstrate a face transplantation model in mice that includes skin, mandible and oral mucosa.

Methods: We developed a new syngeneic face transplantation model composed of skin, mandible, teeth and oral mucosa in C57BL/6 mice. The following assessment included measuring the length of the right incisor on the transplanted mandibles, CT scan in one mouse for mandibular structure evaluation, and histological examination of different tissue samples in other mouse for viability evaluation.

Results: We performed 5 consecutive transplantations. The donor vessels were the common carotid artery (≈0.4mm) and anterior facial vein (≈0.2mm), and the recipients were the common carotid artery and the posterior facial vein (≈0.4mm). The mean operative time for the donor was 80 min, and for the recipient was 123 min. There were neither flap failures nor animal deaths. The follow up was 6 months. The right incisor of the transplant grew at different rates in all cases. Histology samples showed viability in all tissues, including mandibular bone marrow. CT scan demonstrated normal structure of the transplanted bone.

Conclusion: Our syngeneic partial face transplantation model in mice, which included skin, oral mucosa, and mandible with teeth, should be useful for future face allotransplantation research, as the myriad of tissues it provides, of different immunomodulatory functions, is similar to that in clinical scenario.

1Clinical fellow, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital; Chang Gung University and Medical College

2Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

3Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan

4St Andrew’s Center for Burns and Plastic Surgery, Chelmsford, United Kingdom

5Department of General Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan

6College of Medicine, Chang Gung University, Taoyuan, Taiwan

7Department of Plastic Surgery, IPS Universitaria/León XIII Hospital, University of Antioquia, Medellín, Colombia

* These authors contributed equally to this work

Financial Disclosure Statement: The authors declare no conflicts of interest.

Funding: This work was supported by Chang Gung Memorial Hospital, Taiwan, ROC (CMRPG3F1431, CMRPG1F0081, CMRPG1F0082 and NRRPD1H0161).

ACKNOWLEDGEMENTS: This work was supported by Chang Gung Memorial Hospital, Taiwan, ROC (CMRPG3F1431, CMRPG1F0081, CMRPG1F0082 and NRRPD1H0161).

Corresponding Author: Fu-Chan Wei, MD, Center for Vascularized Composite Allotransplantation, Department of Plastic Surgery, Chang Gung Memorial hospital, Chang Gung University and Medical College, No. 5, Fu-Hsing St., Gueishan, Taoyuan 333, Taiwan, ROC. fuchanwei@gmail.com

©2019American Society of Plastic Surgeons