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A tremendous amount of research has been dedicated to laying the groundwork that will eventually lead to successful limb transplantation in humans. Limb transplantation in animal models has also been widely used for evaluating composite tissue allografts and various immunosuppressive regimens. Currently, there is no mouse model of limb transplantation. Such a model is attractive because it would allow investigators to apply the well-defined genetic characteristics of the mouse to the challenging field of limb transplantation. In this study, 12 mice underwent orthotopic hind limb transplantations using end-to-end anastomoses of the femoral vessels. The success rate of this surgical procedure was 83%, with 10 of the 12 limbs surviving. Experimental devices, operative procedures, and the major elements of success are discussed.
Numerous biologic and synthetic materials have been used with limited success as an interposed graft to repair segmental common bile duct (CBD) defects. The authors report here that an autologous vein graft can be successfully used to correct a CBD deficit contingent on accurate microsurgical technique immediate stenting and rapid graft vascularization. Thirty Sprague-Dawley rats underwent laparotomy and the experimental group (n=25) had a 3-mm segment of the CBD excised. The CBD defect was repaired using an interposed femoral vein graft aided by a plastic stent. The control group (n=5) had the CBD cut and repaired by means of primary anastomosis. The experimental group was subdivided into three sub-groups each examined at three different postoperative intervals: 1, 4 and 12 weeks. The results showed that inflammation was apparent in the venous wall following the first postoperative week. A progressive loss of the vascular endothelium and replacement with the columnar epithelium typical of the CBD was seen in the vein graft. Nineteen of the 25 experimental rats (76 percent) of the animals survived without complication from the surgery and there were no abnormalities in the liver biochemical tests of these animals. Any biliary tract obstruction that developed was attributed to dislocation of the stent leading to collapse of the vein graft (experimental group), or constriction of the anastomosis (control group). This study demonstrates that biliary tract reconstruction using an autologous vein graft can be successfully performed in a rat model of CBD repair. The application of this method to the clinical setting is also discussed.
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