Experimental models in primates for reconstructive surgery utilizing tissue transplants

Two experimental models for tissue transplantation between unrelated individuals of a primate species have been designed to study survival and reinnervation. The first is a neurovascular free flap consisting of the entire soft tissue coverage of the index finger. The second is an entire hand transplant through the distal forearm. Ongoing studies show that cyclosporin A at high doses, in combination with a tapering regimen of steroids to a low maintenance level, permits prolonged survival of both transplant models. Careful biochemical, hematological, and cyclosporin A serum trough level monitoring permits use of this drug a very high dosages in primates. Continuing experiments should yield detailed neurophysiological data on the reinnervation of these transplants over the next 6 to 18 months.