Reconstitution of Structure and Cell Function in Human Skin Grafts Derived from Cryopreserved Allogeneic Dermis and Autologous Cultured Keratinocytes

Robert C. Langdon, Charles B. Cuono, Nicholas Birchall, Joseph A. Madri, Elizabeth Kuklinska, Joseph McGuire, Gisela E. Moellmann
1988 Journal of Investigative Dermatology  
Med ici ne, N ew H aven, Conn ecti cut, U .S. A. Grafts of all ogeneic dermis plus autologous epidermal cell cultures were used to replace extensively burned skin. Cryopreserved split-thickness cadaveric skin w as grafted onto debrided burn wounds, and autologous keratinocytes were cultured from uninjured donor sites. Several weeks later, allograft epidermis was abraded and replaced with the keratinocyte cu ltures. The final grafts were thus composites of autologous cultured epidermis and
more » ... neic dermis. In a case with 28 months follow-up , reconstitution of the dermal-epidermal (BMZ.l) and microvascul ar (BMZ.2) basement membrane zones was studied immunohistochemically and ultrastructurally. Immediatel y before grafting, thawed cryopreserved skin reacted with antibodies against laminin and type IV coll agen in normal patterns. Twenty-nine days after graftin g, BMZ.l reacted weakly with both antibodies, and antico ll agen type IV reactivity was absent from BMZ.2. Antilaminin reactivity ofBMZ.2, however, was moderately intense, c~)I1sistent with recent neovascularization. On day 29, S kin grafts, co nsisting of allogeneic dermis and stratified keratinocyte cultures derived from autologous epidermis, have been used to provide skin replacement in six severely burned individuals, o ne of whom has been followed for 28 months [1 ,2]. Debrided burn wounds were first res urfaced w ith cryopreserved, mes hed , split-thickness all ogeneic skin. In each case, donor skin was obtained from severa l cadaveric so urces and was not matched wi th the recipient for transplantation anti gens. Allografts were cons iste ntl y acce pted. Because the allograft epidermis was co nsid ered to be the principal target of eventual immunol ogic rejection [3], it was removed at 3-4 weeks by abrasion . Th e
doi:10.1111/1523-1747.ep12476623 pmid:2459265 fatcat:gdl2w2vzxjhfrd6kfd7qk2dupe