Optimization and Implementation of Long Nerve Allografts

Abstract

Abstract : Loss of nerve function occurs when a nerve is severed. Any significant loss of nerve tissue requires a graft to restore continuity and promote nerve regeneration and recovery of function. Presently, there is no acceptable nerve grafting method for the repair of extensive nerve damage. An acellular nerve allograft product is available for the reconstruction of short to moderate length nerve defects, however, in its present from the allograft is not suitable for the repair of lengthy nerve defects. The aims of this project are to evaluate several long (7cm) nerve allograft technologies. All tasks scheduled for year 1 of this two-year project were completed. A nerve graft processing protocol was established for rabbit peripheral nerve that mimics the production of the human nerve allograft product used clinically. This includes detergent decellularization, treatment with chondroitinase ABC, and irradiation sterilization. A 7-cm, stepping-stone graft was established. A tubular nerve protector biologic was devised. A long nerve allograft model in rabbit was established, including several neurological evaluation methods. Control conditions include a standard acellular allograft and cellular autograft (the gold standard in nerve grafting). At this point, all nerve grafting has been completed on schedule and evaluations of nerve regeneration and recovery of function have begun. If successful this project will establish technologies for the repair of extensive nerve damage using of-the-shelf nerve products that overcome the limitations of nerve autografting.