Nerve Graft Prefabrication by Use of Adipose Tissue Derived Mesenchymal Stem Cell Induced Lateral Axonal Sprouting into the Allogeneic Epineural Sheath Conduit
Huseyin Karagoz, MD, PhD; Ceyhun Cesur, MD; Sinan Ozturk, MD; Erdinc Cakir, MD; Mustafa Tansel Kendirli, MD; Zafer Kucukodaci, MD; Omer Ozcan, MD; Osman Metin Ipcioglu, MD
Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
Introduction: Lack of ideal nerve conduit as effective as autologous nerve graft without donor side morbidity is an important clinical problem. We performed two preliminary studies to prefabricate a new conduit for segmental nerve defect repair1,2. We also compared the effects of this new conduit to autogenous nerve graft3. Although we got encouraging results, the best results were obtained with autogenous nerve graft. Siemionow reported good results with epineural sheath supported with mesenchymal stem sells for repairing nerve defect4.
We aimed to go further with these studies, and to create an autogenous nerve graft substitute as effective as autogenous nerve graft.
Methods: We used 27 Lewis rats. Epineural sheath conduits and fat tissues harvested from the 9 donors. The epineural sheath conduits were sutured to the epineural windows on the sciatic nerves in an end-to-side fashion (figure).
Three groups were created each containing 6 rats. Conduits filled with saline, fat graft and adipose tissue derived mesenchymal stem cells in the first, second and third groups respectively to stimulate lateral axonal sprouting. Following 8 weeks, animals reexplored and epineural sheath conduits were taken. Electrophysiological, histopathological and immunological studies were performed.
Results: Many well-organized myelinated axons were observed in the stem cell group, however the other groups were not include considerable axons.
Conclusions: The new and effective nerve conduit has been created to use nerve defect repair. This is a new research area to investigate for neuroscientists. It's not possible to use it for acute cases since a certain time will be needed to prefabricate the nerve graft. However it can be used easily for secondary surgery such as treatment of neuroma, or the case which is not healed with successful results after first nerve repair.
Back to 2017 ePoster Listing