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Wang et al. Plast Aesthet Res 2018;5:10 I http://dx.doi.org/10.20517/2347-9264.2017.90 Page 7 of 10

Table 5. Hindlimb animal models
Allo-transplantation Approach Graft Regimen References
Primate Mismatched donor to Orthotopic Sensate osteomyocutaneous Tacrolimus 1 mg/kg and mycophenolate [54]
recipient M. fascicularis radial forearm flap mofetil 20 mg/kg;
monkey both every 12 hour, methylprednisolone
15 mg/kg for 3 days followed by
7.5 mg/kg for 2 days and a 50%
reduction every 2 days until the dose was
1 mg/kg
Swine White pig autotransplant Heterotopic Whole forelimb No immunosuppression [55]
Swine Mismatched newborn swine Heterotopic Newborn knee No immunosuppression [56]
Swine Mismatched donor to Heterotopic Skeletal graft consisting of No immunosuppression [57]
recipient pigs the tibia, fibula, knee joint,
distal femur, and surrounding
muscles
Swine Mismatched donor to Orthotopic Osteomyocutaneous forearm No immunosuppression [58]
recipient pigs flap
Swine Mismatched donor to Orthotopic Radial forelimb No immunosuppression [59]
recipient pigs osteomyocutaneous flap
Rabbit NZW autotransplant Orthotopic Whole knee joint No immunosuppression [60]
Rat N/A N/A Cremaster N/A [61]
muscle and pubic bone flap
Rat ACI to WF Heterotopic Hindlimb TBI 600 cGy prior to 1 dose of BMC 100 [62]
6
osteomyocutaneous × 10 cells/kg with tacrolimus
1 mg/kg/day for 10 days and ALS
5 mg on POD10
Rat WF to LEW Orthotopic Simultaneous dual-surgeon No immunosuppression [63]
hindlimb
Rat BN to LEW Orthotopic Vascularized elbow CSA 16 mg/kg/day for first week, tapered [64]
to 2 mg/kg/day, then maintenance
Rat Lewis-BN to LEW Orthotopic IBOMC flap CSA 16 mg/kg/day in 1st week, tapered [65]
to 8 mg/kg/day in 2nd week, to 4 mg/
kg/day in 3rd week and to 2 mg/kg/day
in 4th week and maintained
NZW: New Zealand White; BN: Brown Norway; LEW: Lewis; CSA: cyclosporin A; POD: postoperative day; N/A: not available; WF: Wistar-
Furth; BMC: bone marrow cells; IBOMC: iliac bone osteomusculocutaneous

Table 6. Myofasciocutaneous animal models
Allo-transplantation Approach Graft Regimen References
Swine Mismatched donor to Heterotopic Gracilis myocutaneous No immunosuppression [66]
recipient MGH miniature flap
swine
Swine Mismatched donor to Heterotopic Fasciocutaneous flap TBI 100 cGy and CD3-IT conditioning prior to 3 [67]
recipient MGH miniature doses of HCT 15 × 10 cells/kg with CSA (target
9
swine trough 400-800 ng/mL) for 45 days
Canine Beagles autotransplant Transferred to groin Myocutanenous rectus No immunosuppression [68]
region flap
Rat WKY heart and LEW VCA to Heterotopic heart and Heart and abdominal CSA 5 mg/kg/day every other day for [69]
F344 orthotopic VCA musculocutaneous flap 10 days after heart transplant
LEW: Lewis; CSA: cyclosporin A; TBI: total body irradiation; CD3-IT: CD3-immunotoxin; HCT: hematopoietic cell transplantation; F344:
Fischer 344; WKY: Wistar Kyoto

further focus can be emphasized. Experimental animal surgical models can be difficult to perform and
such research in VCA should be best collaborated with both clinicians and surgeons who can perform the
difficult animal models, as well as basic scientists to further developments in this specialty.

Many of the immunosuppressive regimens used thus far involve an induction agent such as anti-thymocyte
globulin or total body radiation which preconditions the host’s immune system in preparation for a chance
of engraftment of donor antigens. In particular, the phenomenon of chimerism is particularly seen in VCA
research where the transfer of vascularized bone marrow, in long bones in particular, mediates a constant
exchange of cells such as regulatory T cells which serve to protect the allograft. A particular preference for
cyclosporin A, tacrolimus and steroids were seen across each animal model - quite so due to their widespread