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J Thorac Cardiovasc Surg 2008;135:1398-1399
© 2008 The American Association for Thoracic Surgery

Brief Communication

The feasibility of diaphragmatic transplantation as potential therapy for treatment of respiratory failure associated with Duchenne muscular dystrophy: Acute canine model

Alexander Sasha Krupnick, MD*, Andrew E. Gelman, PhD, Mikio Okazaki, MD, PhD, Jiaming Lai, MD, Nitin Das, MD, Seiichiro Sugimoto, MD, Thomas H. Tung, MD, Steven B. Richardson, BS, G. Alexander Patterson, MD, Daniel Kreisel, MD, PhD

Department of Surgery, Division of Cardiothoracic Surgery, Thoracic Immunobiology Laboratory, Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St Louis, Mo

Received for publication September 27, 2007; accepted for publication December 4, 2007.

* Address for reprints: Alexander Sasha Krupnick, MD, Washington University Division of Cardiothoracic Surgery, 660 So Euclid, Campus Box 8234, St. Louis, MO 63110. (Email: krupnicka@wudosis.wustl.edu).

The first 20% of the full text of this article appears below.

Since its introduction several decades ago, solid organ transplantation has had a wide impact as successful therapy for end-stage organ failure. Refinements in surgical techniques have allowed for the expansion of the spectrum of transplantation to replacement of "nontraditional" organs and tissue such as extremity limbs, facial structures, and laryngeal allografts.1Go Duchenne muscular dystrophy (DMD) is the most common and severe of the human muscular dystrophies, affecting 1 in 3500 live male births. Currently no efficacious therapy is available for this disease, and death generally occurs in the late teens to early twenties from respiratory complications resulting from diaphragmatic dysfunction.2Go Diaphragm transplantation could thus represent a novel therapy for this disease. As the ultimate success of transplantation hinges on adequate revascularization, the goal of this study was to develop surgical techniques for orthotopic diaphragmatic transplantation.

Methods, Results and Discussion

The canine model has been used to develop multiple surgical techniques in thoracic organ transplantation, and the experiments described herein were performed in mongrel hounds weighing 25 to 30 pounds. Similar to human beings, the phrenic arteries in the dog branch directly off the abdominal aorta and are reported to act . . . [Full Text of this Article]






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