A feasibility study of salivary gland autograft transplantation for xerostomia

Background. Radiation-induced xerostomia is a frequent sequela in patients treated for cancer of the head and neck. One strategy to treat xerostomia w ould be to relocate portions of salivary tissue to adjacent submucosal site s that lie outside the radiation portals such as the anterior oral vestibul e. It is not known whether salivary tissue transplanted as an autogenous fr ee graft can survive, function adequately, and not produce mucoceles. Methods. Salivary grand tissue from the parotid and submandibular glands of the Syrian hamster were transplanted into the submucosal layer of the chee k pouch. After 3 months of observation, looking at graft size, graft extrus ion, ulceration, infection, and mucocele formation, the graft sites were ha rvested. The specimens then underwent pathologic analysis by hematoxylin an d eosin staining, as well as immunohistochemical methods to determine posit ivity for cytokeratin, smooth muscle actin (SMA), and amylase. Results. Histologic analysis of tissue harvested from Syrian hamsters graft ed into the cheek pouch demonstrated intact, viable, organized salivary gla nd tissue. Eighty percent of the animals in the submandibular group and 63% of the animals in the parotid group had at least 1 graft with viable saliv ary tissue without undue complications. Conclusions. Salivary gland tissue can be transplanted successfully as free autogenous grafts in the Syrian hamster model. Further studies are needed to determine whether the grafts will subsequently become functional and whe ther growth can be biologically stimulated. This approach may be a useful s trategy to protect salivary gland tissue in patients undergoing radiotherap y for head and neck cancer. (C) 2000 John Wiley & Sons, Inc.