Predegenerated nerve autografts as compared with fresh nerve autografts in freshly cut and precut motor nerve defects in the rat.
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Animals↗
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Free autografting of entire limb muscles in the cat: histochemistry and biochemistry.
Fifty extensor digitorium longus muscles of 25 cats were autografted, 33 with and 17 without prior denervation. After 50 days, no significant differences were observed between predenervated and nonpredenervated autografts. Autografted muscles weighed 48% of the weight of control muscles. Few original muscle fibers survived and within 2 wk autografts contained regenerating muscle fibers. The mean cross-sectional area of muscle fibers in the autografts reached 125% of the value for control nontransplanted muscles. The mean percentage of fibers classified high oxidative in autografted muscles was 67% of values for control muscles. SDH activity of autografted muscle homogenates reached 55% of control values. Up to 60 days after surgery autografts had only fast-twitch fibers. At 170 days autografts remained 95% fast twitch in composition. Revascularization began within 4 days, but the capillary to fiber ratio of long term autografts reached only 60% of control values. Although fiber hypertrophy suggests that cats use autografted muscles, lower than control succinate dehydrogenase activity may result from altered recruitment.
Action Potentials↗
Long term performance of 580 homograft and autograft valves used for aortic valve replacement.
Homograft valves have been used at the National Heart Hospital since 1964, and autograft valves since 1967. The homografts were treated either by freeze drying, by flash freezing, or by tissue maintenance in a nutrient medium (fresh). In order to compare these three groups of homograft valves with the autograft valves some long term assessment of valve function was required. In the whole group of 580 valves there have been 40 late deaths, which is a probability of only 7% over 6 to 14 years. Homografts and autografts are therefore excellent valves in terms of patient survival. Thromboembolism, haemolysis and bleeding may be regarded as complications which do not occur with homograft and autograft valves. There was one thrombogenic episode in this group, an incidence of one per 11,994 patient years and a probability of only 0.000083 patient years. Potentially fatal hazards of late complications with homoor autograft valves decrease with time and at this time is a negligible factor. The similarity in pattern of onset of late infections and degeneration probably reflects the greater susceptibility to infection of a degenerating valve. All three groups of homografts are very similar and differ only from the excellent performance of the autograft valves.
Aortic Valve↗
Regeneration of acini in submandibular gland autografts.
Regeneration of submandibular gland (SMG) secretory parenchyma is remarkably impaired in salivary gland diseases and under experimental conditions such as in tissue culture and after isografting. In our study acinar regeneration was found to depend on the site where the SMG tissue was implanted. Implantation of several 2-3 mm3 fragments of SMG subcutaneously in the back of the same donor adult male rat resulted in initial necrosis and mononuclear cell infiltration of the autograft. Then there was epithelial proliferation with the appearance within 28 days of lobules which contained numerous duct-like structures and only a few or no acini. In contrast, implanting SMG fragments in the anatomical bed of the donor gland resulted in the appearance of a more differentiated autograft. Although the initial tissue changes were similar to those seen in the autografts in the subcutaneous tissues of the back, the SMG autograft in the neck also contained numerous acini by 42 and 56 days after implantation. These data support the view that the implantation site influences the course of cytodifferentiation in SMG autografts.
Animals↗
Skin cell suspension autograft as an evidence-based innovation in burn and wound treatment: A systematic review of global evidence across two decades.
BACKGROUND: Skin cell suspension autograft (SCSA) is a point-of-care approach to wound management facilitating epithelialization while reducing burden associated with conventional autografting. Despite growing clinical use of SCSA across diverse wound etiologies, the global clinical evidence describing its use has not yet been comprehensively synthesized. METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines to identify studies between January 2000 and December 2024 reporting clinical use of SCSA for wound closure. Data on patient demographics, wound characteristics, and treatment methods were extracted. Clinical, safety, and health economic outcomes were extracted for comparative studies evaluating SCSA against control treatments. RESULTS: Ninety-nine studies across 13 countries were included. Across the overall dataset, SCSA was used alone or in combination with autografting for burns, surgical wounds, traumatic injuries, inflammatory conditions, and chronic wounds. Among comparative studies (n=27), SCSA consistently reduced donor skin, and healing outcomes favored SCSA in 61%, while 39% reported equivalent outcomes. Pain and esthetic outcomes more frequently favored SCSA, while safety outcomes were generally similar, with some studies favoring comparators. Health-economic outcomes suggested potential reductions in length of stay and resource utilization, although findings were variable across studies. CONCLUSION: The available global evidence supports SCSA as a versatile modality for supporting epidermal coverage across wound types and clinical contexts. However, the findings should be interpreted in the context of the limitations of this review, which include heterogenous study designs, variable outcome reporting, predominance of non-randomized data, and the absence of a formal quantitative analysis. Nevertheless, the demonstrated clinical and economic benefits in comparative studies reinforce the role of SCSA as an evidence-based innovation for burn and wound treatment.
Humans↗
Aortorenal arterial autografts.
Forty-nine iliac artery autografts were used in the treatment of renovascular hypertension in 45 patients, including six children. The pathological process was fibromuscular dysplasia in 42, atherosclerosis in two, and Takayasu arteritis in one. The internal iliac artery was used as a graft in 39 patients. The common iliac bifurcation was used in two patients, and the external iliac artery in four patients. Common and external iliac artery continuity was restored with Dacron prostheses. Forty-three patients with 47 autografts have been followed up from one to ten years (average three years). Hypertension was cured or improved in 96% of the patients. Serial follow-up arteriograms as late as ten years after surgery have been obtained in 50% of the patients. No late occlusions occurred. Slight autograft dilation occurred seven years postoperatively in one child. Normal growth of the autograft was exhibited in the remaining five children. No evidence of dilation, aneurysm formation, or stenosis appeared in any other grafts, although one patient developed a new lesion distal to her graft.
Adolescent↗
Long-term results of pulmonary autograft for aortic valve replacement.
Eighty-five survivors who left hospital after pulmonary autograft replacement for severe aortic regurgitation have been followed critically. Five patients died in the first five years and 80 were followed for six to 11 years. Important aortic regurgitation occurred only early and was always related to technical malpositioning of one autograft cusp. Seven patients with fascial pulmonary valves had problems, requiring removal in four. There was a small (2%) morbidity from the right sided homograft and six were removed five to seven years later for progressive calcification; three of these had been irradiated. Despite a high incidence of trivial diastolic murmurs this valve replacement is still preferred for young patients without dilated aortic roots since the survivors remain well, with excellent, maintained relief of outflow obstruction, without problems from haemolysis and thromboembolism, and without deteriorating autograft function or need for anticoagulants. Histology of five autografts examined up to seven years after operation has shown normal living architecture.
Adolescent↗
The induction of new bone and cementum formation. IV. Microscopic examination of the periodontium following human bone and marrow allograft, autograft and nongraft periodontal regenerative procedures.
This retrospective study based on histologic evaluations of 100 human block sections and extracted teeth taken from sites treated via bone and marrow autograft, allograft and nongraft regenerative procedures revealed the following findings: 1. Graft procedures yielded new cementum formation in 66 of 79 sites evaluated while nongraft approaches yielded new cementum formation in only 7 of 21 sites. Two of the grafted sites not yielding new cementum were only 14 days duration. 2. Block section evaluation revealed new bone formation in 33 of 39 graft sites and in 7 of 21 nongraft sites. 3. When regeneration did occur, as seen in the block sections, the nature of the new attachment was similar in all graft approaches and was comparable to healthy functioning periodontium. 4. The potential for regeneration of a functional attachment apparatus including new cementum, bone and functionally oriented periodontal ligament has been demonstrated in autograft and allograft approaches. 5. Adverse immune response to bone and marrow allografts could not be detected at a clinical, histologic or chemical level. 6. No ankylosis or root resorption was noted with fresh intra-oral donor material and with frozen iliac autografts or allografts. Root resorption was noted in two cases treated with nongraft methods and in 16 of 275 sites treated with fresh iliac autograft material.
Alveolar Process↗
A roentgenographic evaluation of frozen allografts versus autografts in anterior cervical spine fusions.
Serial roengenograms of 53 patients who had 76 cervical interspaces grafted with frozen, bone marrrow-free cadaver bone were compared to those obtained from 45 patients who received 63 iliac crest autografts for anterior cervical spine fusion. The roentgenograms were evaluated on the basis of achieving union, delayed union, non-union, and the presence of graft collapse and extrusion. No significant difference was noted in the union rate, with allografts (94%) or with autografts (97%). In 21 patients a higher rate of graft collapse was noted with allografts as compared to autografts in multilevel fusions. In these patients, allograft rejection or the biomechanical properties of the allograft may have contributed to a difference in the rate of graft collapse with cadaver bone. No difference in collapse rate was noted between allografts and autografts in 32 patients with single level fusions. Insertion of frozen bone allografts into intervertebral spaces of the cervical spine has not produced adverse reactions.
Bone Transplantation↗
Subglottic enlargement using cartilage-mucosa autograft. A preliminary experimental study.
Subglottic stenosis in the infant currently has no well-accepted surgical correction. Our experimental study was designed to determine the effectiveness of a nasal septal cartilage-mucosa autograft in increasing the subglottic circumference and its effect on subsequent subglottic growth. Six pairs of matched mongrel puppy litter mates were used; one underwent surgery, the other served as a control. The cricoid and first tracheal rings were split anteriorly, and widened 5 mm to accept an autogenous nasal septal cartilage-mucosa graft. All animals were killed after six months of postoperative growth. The autografts appeared to be partially or completely replaced by fibrous tissue but a persistent enlargement in the subglottic airway was found in the animals that underwent surgery, with glottic measurements the same in both groups. Thus, a septal cartilage autograft to the subglottic larynx in puppies appears to result in persistent enlargement of the subglottic area, but produces no interference with subsequent normal laryngeal growth and development.
Animals↗
Prolonged survival after immunotherapy (irradiated cancer autografts) or mammary cancers, assessed by a measure of therapeutic deficiency.
Sixteen women, twelve with stage 2 and four with stage 3 mammary cancers, were given autografts of irradiated cancer cells immediately after simple mastectomy and before postoperative radiotherapy, as a pilot trial with entry limited for ethical and operational reasons. Entry was based upon the presence of the poor prognostic features of tumor diameter exceeding 4 cm, fixation to skin or fascia or presence of axillary lymph nodal metastases. Actuarial survival curves for a period of six years show significant (p less than 0.01) prolongation of survival of the small autografted group (63% at six years) compared to that (30% at six years) of 139 ungrafted stage 2 mammary cancer patients treated by mastectomy and postoperative radiotherapy. The concept of deficiency of a treatment based upon person-years lived is introduced and used to analyze the data. The observations and analyses support the theoretical concept that irradiated autografts of cancers may sensitise residual cancer to subsequent conventional radiotherapy and in the process can activate systemic immunological restraints.
Adult↗
Fine structure of the corpus luteum of the autografted ovary in the rat.
The rat ovary has been transplanted successfully to subcutaneous tissue areas by several investigators. Light microscopy has revealed that corpora lutea in ovarian autografts are formed by luteinization of intact follicles and contain entrapped ova. In the present study, corpora lutea from autografted ovaries in castrate rats were obtained at metestrus and examined electron microscopically to determine whether their cellular morphology correlated with the normal progesterone levels in these animals. Cellular features usually accepted as regressive were apparent. The findings suggest either structural luteolysis is occurring before functional luteolysis or that the adrenal has increased steroidogenic activity in the castrate with ovarian autografts to account for the normal progesterone levels.
Animals↗
Early tangential excision and immediate mesh autografting of deep dermal hand burns.
Thermal injuries to the hand constitute not only one of the most common burns, but one of the most difficult for the burn surgeon to treat. Early wound closure is mandatory if maximum functional return is to be attained and scarring minimized. Over the last three and one-half years, 60 patients with deep dermal dorsal hand and finger burns were treated by tangential excision and immediate mesh autografting. All patients were admitted to the hospital within 24 hours of injury and excision was performed between the third to the tenth post burn day. Operative technique consisted of sequential eschar excision using the Humby knife or Goulian-Weck dermatome until viable dermis was visible. Mesh autograft, ratio 1 to 1(1/2) without expansion, was applied. There was 100% graft take in all but four hands. Hand function with full range of motion returned by the tenth postoperative day. Complications were minor. Patient follow-up ranged from six months to three and one-half years. No patient has required subsequent surgery for scar revision or contracture release. Range of motion in all patients has been excellent and all patients have continued to maintain normal hand function. The cosmetic appearance has been good except for the early "mesh" appearance of the graft which has become less apparent with time. In summary, early tangential excision and immediate mesh autografting of deep dermal dorsal hand burns has fulfilled the following burn principles-preservation of tissue, prevention of wound infection, maintenance of function and early wound closure.
Adolescent↗
In utero fetal lamb thyroidectomy and thyroid autograft transplantation.
Our fetal surgical model was utilized to perform in utero fetal lamb thyroidectomy and autograft transplantation of thyroid tissue to fetal thigh at 82-93 days gestation. Successful in utero transplantation was possible in two of six experimental animals. In one twin pregnancy with an unoperated control lamb, observations were continued to age six months. The athyrotic lamb with a thigh autograft was larger at birth and had a transient weak sucking reflex and awkward gait. It then grew and developed normally with no stigmata of cretinism or delay in bone maturation. At age six months an increase in thyroid stimulating hormone (oTSH) was the single distinguishing observation in the twin with the transplant. Although oTSH levels were elevated to age six months, the pituitary continued to be responsive to thyrotropin releasing hormone (TRH) stimulation. These findings suggest that in utero transplantation of thyroid tissue is technically feasible and that the previously described development of in utero cretinism following fetal thyroidectomy can be prevented by a functioning autograft. This technique will be useful in attempting allograft transplantation in utero.
Animals↗
Long term comparison of fresh arterial allografts and autografts for coronary artery bypass in dogs.
Femoral artery grafts were anastomosed end-to-end to the left internal mammary artery proximally and end-to-side to the circumflex coronary artery distally in 21 adult mongrel dogs. Fourteen dogs received allografts and seven received autografts. All autografts studied from one to 11 months were patent. Eleven of the fourteen homografts studied from one to thirteen months were occluded. Histologically, extensive interstitial edema and leukocytic infiltration with subintimal fibrosis and thrombotic occlusion were seen. This study shows that fresh arterial autografts have excellent long term patency, but that most arterial allografts have early thrombotic occlusion.
Animals↗
Function of lower lung lobe autograft in experimental animals.
The changes in ventilation, gas exchange, blood gases, and acid-base balance, as well as the compensatory capacity of the autotransplanted lung lobe, were studied in 30 dogs with an uncomplicated course following autotransplantation of the lower lobe of the left lung. The studies demonstrated that in the early postoperative period some deterioration in ventilation and gas exchange is noted in the autografted lobe which results in the development of arterial hypoxemia and metabolic acidosis. A normalization of the ventilation and gas exchange is observed in the beginning of the late postoperative period (3 months after surgery). As judged by the functional test with the exclusion of the right (intact) lung from respiration, the compensatory capacity of the autografter left lower lobe remained reduced for a long time after surgery. The author noted no restoration of the Hering-Breuer reflex on the side of the autografted lung lobe, the maximum follow-up period being 7 1/2 years.
Acid-Base Equilibrium↗
Ten years' experience with pulmonary autograft replacements for aortic valve disease.
Pulmonary autograft valves have been used to replace isolated, diseased aortic valves for 10 years, with a long-term survival of 73%. The low incidence of degeneration supports the principle that the autograft valve is a potentially permanent valve replacement. Operative mortality is now less than 5%, despite the longer, more complex operation. The current use of fresh homograft valves for the pulmonary replacement has contributed to these excellent long-term results.
Adolescent↗
Historical aspects in the development of venous autografts.
During the past 75 years much progress has occurred in the field of vascular surgery. During this period, contributions from clinical surgeons have stimulated new scientific discoveries which have led to further clinical applications in a mutually perpetuating cycle of surgical advancement. One of the major achievements has been the use of the venous autograft employed as an arterial substitute. First used by Goyanes in 1906 to replace a popliteal aneurysm, a venous autograft was first successfully employed in the United States by Bernheim in 1915. The stepwise development of this aspect of modern vascular surgery is presented, and the role of other related contributions in making its use feasible is reviewed.
Aged↗