Clinical applications of peripheral nerve allotransplantation. Present medical experience and review of the literature

: Nerve autograft has become recently the gold standard for the reconstruction of surgical nerve gap. Functional results of using this technique continue to improve with the advances in micro-neurosurgery and with greater understanding of neurobiology and nerve regeneration. Surgical reconstruction of extensive nerve injuries frequently exhausts the patient's own source of expandable autogenous nerve grafts. Nerve allografts would offer a limitless supply of graft material. The requirement of only transient immunosuppression to support the regeneration of host axons across the nerve allograft toward distal host receptors renders the nerve allograft an advantageous option for these otherwise irreparable nerve injuries. The methods of graft harvesting, preservation and patients' immunosuppressive regimen as well as the clinical outcomes following the nerve allotransplantation are discussed.