Reconstruction of Critical Nerve Defects Using Allogenic Nerve Tissue: A Review of Current Approaches.

Tim Kornfeld,Anton Borger,Christine Radtke

doi:10.3390/ijms22073515

Tim Kornfeld, Anton Borger + Show 1 more

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https://doi.org/10.3390/ijms22073515

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Abstract

Regardless of the nerve defect length, nerve injury is a debilitating condition for the affected patient that results in loss of sensory and motor function. These functional impairments can have a profound impact on the patient’s quality of life. Surgical approaches for the treatment of short segment nerve defects are well-established. Autologous nerve transplantation, considered the gold standard, and the use of artificial nerve grafts are safe and successful procedures for short segment nerve defect reconstruction. Long segment nerve defects which extend 3.0 cm or more are more problematic for repair. Methods for reconstruction of long defects are limited. Artificial nerve grafts often fail to regenerate and autologous nerve grafts are limited in length and number. Cadaveric processed/unprocessed nerve allografts are a promising alternative in nerve surgery. This review gives a systematic overview on pre-clinical and clinical approaches in nerve allograft transplantation.

Highlights

Loss of motoric function and sensitivity in the distributed region of a peripheral nerve has a considerable impact for patients suffering peripheral nerve injuries [1]
The results indicate that cold-preserved allografts seeded with autologous Schwann cells were able to mediate a sufficient axonal regeneration within the time of observation
The major results of this research project were the assumption that an increasing expression of senescence markers limit the axonal regeneration possibilities on critical nerve defects

Summary

Introduction

Loss of motoric function and sensitivity in the distributed region of a peripheral nerve has a considerable impact for patients suffering peripheral nerve injuries [1]. In 2.8% of all cases, peripheral nerve injuries are associated with severe trauma [4]. In cases where the proximal and distal nerve stumps are tension free adaptable, primary nerve suturing can be performed [8]. If this is not achievable other surgical techniques must be employed. The current clinical gold standard for peripheral nerve defects with a significant gap between the proximal and distal nerve stump is autologous nerve transplantation [9,10]. The major disadvantage of this technique is the limitation of suitable donor nerves and donor site morbidity

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