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Comparable functional motor outcomes after repair of peripheral nerve injury with an elastase‐processed allograft in a rat sciatic nerve model
Author(s) -
Hundepool Caroline A.,
Bulstra Liselotte F.,
Kotsougiani Dimitra,
Friedrich Patricia F.,
Hovius Steven E.R.,
Bishop Allen T.,
Shin Alexander Y.
Publication year - 2018
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30371
Subject(s) - medicine , sciatic nerve , isometric exercise , nerve injury , decellularization , gastrocnemius muscle , surgery , muscle atrophy , peripheral nerve injury , transplantation , compound muscle action potential , ankle , anesthesia , anatomy , skeletal muscle , electrophysiology , biomedical engineering , tissue engineering
Background A bridging nerve autograft is the gold standard for the repair of segmental nerve injury that cannot be repaired directly. However, limited availability and donor site morbidity remain major disadvantages of autografts. Here, a nerve allograft decellularized with elastase was compared with an autograft regarding functional motor outcome in a rat sciatic segmental nerve defect model. Furthermore, the effect of storage on this allograft was studied. Methods Sixty‐six Lewis rats (250–300 g) underwent a 10‐mm sciatic nerve reconstruction using either a cold‐ ( n = 22) or frozen‐stored ( n = 22) decellularized nerve allograft or an autograft ( n = 22). Sprague–Dawley rats (300–350 g) served as full major histocompatibility complex‐mismatched donors. Functional motor outcome was evaluated after 12 and 16 weeks. Ankle angle, compound muscle action potential (CMAP), isometric tetanic force, wet muscle weight, and histomorphometry were tested bilaterally. Results For CMAP and isometric tetanic force, no significant differences were observed between groups. In contrast, for ankle angle, histomorphometry and muscle weight, the cold‐stored allograft performed comparable to the autograft, while the frozen‐stored allograft performed significantly inferior to the autograft. At week 16, ankle angle was 88.0 ± 3.1% in the cold‐stored group, 77.4 ± 3.6% in the frozen‐stored group, and 74.1 ± 3.1% in the autograft group ( P < .001); At week 16, the muscle weight showed a recovery up to 71.1 ± 4.8% in the autograft group, 67.0 ± 6.6% in the cold‐stored group, and 64.7 ± 3.7% in the frozen‐stored group ( P < .05). Conclusions A nerve allograft decellularized with elastase, if stored under the right conditions, results in comparable functional motor outcomes as the gold standard, the autograft.