The Plastic Surgery Foundation
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Grants We Funded

In 2019, The Plastic Surgery Foundation (The PSF) awarded 33 investigator-initiated projects and allocated $891,274 to support the newest, clinically relevant research in plastic surgery.

The American Society of Plastic Surgeons/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.

Research Abstracts

Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area, or PSF funding mechanism.

Nerve Allotransplantation: Immunologic Investigation & Modulation

Principal Investigator
Santosh Kale MD


Washington University in St. Louis

Funding Mechanism
Pilot Research Grant

Focus Area
Composite Tissue Allotransplantation, Microsurgery

Repair of large nerve injuries relies upon reconstruction from autologous sources. These repairs are limited by the amount of available autograft and donor morbidity. Nerve allograft transplantation provides a temporary scaffold for host nerve regeneration and allows for the repair of nerve injuries. They have the advantages of requiring temporary immunosuppresion, decreased donor morbidity, and are abundant in supply. We seek to characterize the immunological mechanisms involved in nerve allograft rejection, and the effects of costimulatory blockade and cold preservation on allograft survival. The immune response, is triggered by two distinct extracellular signals. The first, occurs with antigen(Ag) presentation on major histocompatibility complexes (MHC) to T-Cell receptors (TCR). The second, occurs with co-stimulatory molecule binding to specific TCRs. The first signal, antigen presentation, can occur via the direct or indirect pathway. In the direct pathway, donor Antigen Presenting Cells (APCs) present Ag on donor MHCs to TCRs. In the indirect pathway, recipent APC present Ag on recipient MHCs to TCRs. The second signal, co-stimulatory molecules bind to TCRs and regulate the activation and expansion of alloreactive T-cells. Two well established methods to modulate the immune response include cold preservation and co-stimulatory blockade. Cold preservation of nerve allograft has been shown to reduce antigenicity through decreased expression of donor MHCs. Co-stimulatory blockade has been shown to blunt the activation and expansion of alloreactive T-cells and lead to longer allograft survival. We will isolate the direct and indirect pathways using MHC deficient mice. Nerve allograft will be used to repair sciatic nerve defects. Using return of muscle function, muscle reinnervation, and histologic axon growth as end points, we can assess the pathway of dependency, and the effects of co-stimulatory blockade and cold preservation in nerve allotransplantation.

Dr. Santosh S. Kale is currently a plastic surgery resident at Washington University School of Medicine. His current research interests include nerve transplantation and management options for high peripheral nerve injuries. Dr. Kale earned his bachelor’s degree in Chemistry and Economics at Cornell University, and graduated Magna Cum Laude with distinction in all subjects. He earned his M.D. and MBA from the University of Illinois, and graduated Alpha Omega Alpha.