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Allogenic grafting of vascularized bone segments under immunosuppression. Clinical results in the transplantation of femoral diaphyses
Authors:M H Kirschner  Frithjof D Wagner  Andreas Nerlich  Walter Land  Volker Bühren  Gunther O Hofmann
Institution:Department of Surgery, Klinikum Gro?hadern, Ludwig-Maximilians University Munich, Marchioninistra?e 15, D-81 377 München, Germany Fax: + 49 89 7095 4353 e-mail: kirschner@icf.med.uni-muenchen. de, DE
Trauma Center Murnau, Professor Küntscher Stra?e 8, D-82 418 Murnau/Staffelsee, Germany, DE
Institute of Pathology, Ludwig-Maximilians University Munich, Thalkirchnerstra?e 36, D-80 337 Munich, Germany, DE
Abstract:Trauma surgery lack, substitute, for the reconstruction of large defects of the long bones. Encouraged by the promising results of bone allotransplantation in animal models, we successfully performed vascularized bone transplantation in humans. Vascularized femoral diaphyses were allogenically transplanted into three patients suffering from chondrosarcoma or post-traumatic osteomyelitis with postoperative immunosuppression. The bone segments were harvested from multi-organ donors and perfused with UW solution. After back-table preparation, the grafts were transplanted into the defect zone. Interlocking devices were used in these operations. Vascular anastomoses were performed in end-to-side technique. The early clinical course of the patients was not free of anatomical, technical, or immunological complications. However, all patients are currently free of malignancy and infection. They are also free of pain and full weight bearing. We conclude that allogenic grafting of vascularized bone segments has the potential to become an alternative for the replacement of large bone defects. Received: 21 July 1997 Received after revision: 17 December 1997 Accepted: 9 January 1998
Keywords:Bone transplantation  immunosuppression  Immunosuppression  bone transplantation
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