ALLOGENEIC TRANSPLANTATION OF THE RADIAL SIDE OF THE HAND IN THE RHESUS-MONKEY .1. TECHNICAL ASPECTS

Since allogeneic transplanation of extremities can only be considered if uneventful long-term survival and functional recovery can be achiev ed, a series of 12 transplantations of the radial side of the hand wer e performed in rhesus monkeys so that these factors could be assessed. The transplant incorporated the first ray of the hand in conjunction with the radial forearm flap. Graft survival times varied from 21 to 1 79 days. Ten of 12 transplants showed rejection. In 2 of the 10, rejec tion could be reversed. Immunosuppressive therapy consisted of cyclosp orin A, prednisone, monoclonal antibodies, and preoperative third-part y blood transfusions. Monitoring of the microcirculation of the allogr aft could not provide a predictive value for transplant rejection. The first clinical signs of sensory and motor function recovery were dete cted after an average of 42 and 44 days, respectively. Indefinite unev entful allograft survival could not be established. Major complication s such as sepsis, shock, and lymphoma development leading to death wer e encountered. The model, however, is technically feasible, and the re sults for functional recovery under immunosuppression are promising.