Peripheral nerve allotransplantation

Philipeaux and Vulpian were credited with the first description of peripheral nerve allograft (PNA) in dogs in 1863. While all the allografts failed, their continued work on nerve autografts yielded important observations still true today - they noted that the sensory lingual nerve was able to function as an autograft in the hypoglossal motor nerve, and tested this function using in vivo electrical stimulation.1 In 1885, Albert reported first two clinical cases of nerve reconstructions, a 3-cm median and 10-cm ulnar nerve gaps, using segments from amputated lower extremities. The follow-up was only 10 days, and Huber subsequently reported graft necrosis of the second case within a week of transplantation. Mayo- Robson reported one early case of successful nerve allograft in 1889 in a 12-year-old girl, who received a 2.5-in. posterial tibial nerve graft from an amputated leg of another patient to the median nerve of her hand. However, subsequent attempts at nerve allotransplantation were met with failures.