Effect Of Insulated Draining Lymph In Composite Tissue Allograft-transplantation

BackgroundIn the following fifty years after the first successful organ transplantation，CTA has been hardly vanished.It is attributed to the strong antigenicity of skinand lacking of effective measurement of immunosuppression which have beenthe unconquerable obstacle of composite tissue allotransplantation.With theinvention and application of new immunosuppressant and the maturation ofmicrosurgery technique， CTA has been widely applied in plastic andreconstructive surgery. But the toxic effects which caused by takingimmunosuppressant for a period of time is still the constraint of CTAdevelopment。Insulated draining lymph node may become the breakthroughpoint when we try to tackle with this problem. Draining lymph nodes are veryimportant in skin and cornea transplantation. After skin transplantation on cavywhere corresponding Draining lymph nodes had been excised，the survival timeof allograft has been prolonged. Bone marrow derived cells such as Langerhanscells in cornea can migrate to local Draining lymph nodes after CTAtransplantation，which can present alloantigen and trigger corneal immunologicrejection. So，isolation between allograft and receptor can，on the one hand，cut off the route which antigen-presenting cells（APC）and activated Tcells gothrough to Draining lymph nodes，also can，on the other hand，block the way that effector Tcells go through to allograft thereby prolonging the survival time.This experiment has successful established the model of Insulated draininglymph CTA of hypogastrium in rats and conspicuously prolonged the survivaltime of allograft。Purpose(1) To establish the rat experimental model of isolated draining lymph(2) Verify the lymphatic drainage relative to the vascular pedicle is the main wayto start the immune rejectionMethodExperimental NO.1(1) Rat whole-body anatomy, familiar with the anatomicalstructures in rats isolated for rat model and to flaps choose to provide theoreticaland practical basis.(2) Familiar with the anatomy in rats on the basis of theadvantages and disadvantages of various flaps (back flap, the facial flap, flap ofthe lower abdomen, lateral chest flap) in rats, to determine the experimentalisolation model selected flaps.(3) Isolation model by comparing the rubber pad,plastic tube to isolate the model, the advantages and disadvantages of plasticpallets and wire fixed model to determine the isolation of the experimentalmodel. To determine the free flaps and isolated lymphatic drainage of the ratexperimental model of vascular anastomosis by microsurgical free flap group ofrats from body free flap, the flaps are divided into three groups, respectively (forflap directly by the District suture without isolation), the suture of the skin tubegroup (the donor flap rolling tube with area), the isolated group (experimentalrat isolated model). Were observed after the flap blood supply and groping aftersurgery fixed and derived methods. Experiment2The SD rat free flap and skintube transplantation, isolated model of rat composite tissue transplantation lymphatic drainage.7-8week old male SD rats were cut to remove theabdominal skin flap and free line allograft, skin and lymphatic isolation group(A): the edge of the donor flap together, stitched into a tube, bottom left vascularpedicle export Isolator isolation, microsurgical vascular anastomosis, suture ofthe skin tube in the isolator, the isolator fixed on the receptor; simply the bloodvessels of the skin tube group (group B): free flap donor volume made of tubular,microsurgical anastomosis and hose directly sutured to the recipient; C groupblank control group (group C): free flap allograft general observation in eachgroup flap and skin tube survival time after3,5,7,14,28,35d take a skin grafttissue HE staining to observe pathological changes.ResultExperiment NO.1Rat back flap, the facial flap, the anatomy of the lowerabdominal flap and lateral thoracic flap and transplantation contrast, lowerabdominal flap has anatomic structures clearly and supply vessels formicrosurgery suture, postoperative observation and material relatively simple, itis selected as the experimental flaps. Postoperative fixation and isolation rubberpad isolation, isolation of plastic pipe and plastic tray plus the contrast of barbedwire fixed three isolation model, the plastic tray and wire fixed model wassignificantly better than the other two models, it is selected as the experimentalisolation model. Abdominal free flap were satisfied with the three differentgroups of transplant in the formof rats survived, isolated ratexperimentalmodel of lymphaticdrainage is established successfully.Experiment2A (isolated group): hose survival time was32days (34,32); groupB (skin tube group): hose survival time was15(16,15) days; group C (controlgroup): flap survival time was6(7,6) days. Group A and group C, group B andgroup C, group A and group B, survival differences were statistically significant (P <0.05).ConclusionIn this study successfully established a rat composite tissue transplantationlymphatic drainage isolation model, and confirmed that this model caneffectively prolong graft survival time.