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Progressive fatal dementia (Creutzfeldt-Jakob disease) in a patient who received homograft tissue for tympanic membrane closure.

We report the case history of a 54-year-old man who developed a fatal neurological disorder 4 years after a successful tympanoplasty with homograft pericardium. The final diagnosis of this case was Creutzfeldt-Jakob disease. This infectious spongiform encephalopathy is probably caused by a slow virus that can be transmitted by transplantation materials. The possible accidental transmission of Creutzfeldt-Jacob disease by the use of homograft materials in otologic surgery is discussed.

Cerebral Cortex↗

Preservation of otologic homografts.

Techniques for preservation of homografts for replacement of tympanic membranes, ossicles, closure of the oval window, and canalplasty remain controversial. Review of 300 articles reveals no evidence opposing the harvesting of grafts from living patients or cadavers, or the prolonged storage of these materials in antibacterial solutions. It appears to be important to store the grafting material long enough to reduce antigenicity. Numerous techniques and materials are being used with success. Additional research on antigens, histologic fate of grafts, long-term success, and complications is essential to determine ideal grafting materials, preservatives, and techniques.

1-Propanol↗

[Comparative study of the effect of different chemical procedures on the antigenicity of allogenic transplants of the human trachea].

Replacement of long tracheal segments poses some unsolved problems, specially the undisponibility of an adequated substitution material. This study deals with some of the immunological aspects of the transplantation and preservation of human tracheal grafts. Since immunological rejection occurs in the first place as a consequence of incompatibility for class II antigens (HLA-DR, -DP and -DQ), their presence and distribution was studied using monoclonal antibodies and the immunoperoxidase method. Class II expressing cells were recognized in the mucosa and the mixed glandular tissue. Furthermore we investigated the influence of different preservation methods on the antigenicity of tracheal allografts. The results showed a total destruction of these antigens. We can conclude that chemically preserved human tracheal allografts are immunologically suitable for reconstructive surgery of the trachea.

Cialit↗