Limb Allografts

Abstract

Surgeons have been dreaming of reconstructing a defective limb (or trunk) through limb allotransplantation, but rejections as well as the ethical and moral values have greatly strangled the development of limb allotransplantation in clinic practice. Since 1960s when organ transplantation and the first replantation of severed limb were reported, many scholars have carried out experimental study of limb allotransplantation, only to find a great variety of obstacles on the way. Also occasionally clinicians carried out finger allograftings in which no anti-rejection measures were taken or even wrong allogenic fingers connected. Their results could be imagined. However, since Ecuador failed a limb allograft in 1964, there has been a successful allograft surgery in the world. With the progress in organ transplantation and immunology in recent 10 years, limb allotransplantation has been a great concern of the orthopaedic surgeons all around the world. In 1966 Goldwyn successfully performed the first dog limb allograft with mercaptopurine and azathioprine as the immunosuppressants. Furnas and Fritz respectively reported use of cyclosporine A as an immunosuppressant in the mouse limb allograft model. In spite of immune rejection of the skin, the survival time of all tissues was prolonged, and the CsA was more effective and less toxic than the broad spectrum immunosuppressants. In 1983 Arai et al. used FK506 as an immunosuppressant in limb allotransplantation in mice in which the short-term survival time of the graft after treatment was significantly prolonged.