Table 7.

Advantages and disadvantages of the various protocols to decellularize nerve grafts.

Decellularization protocol	Advantages	Disadvantages
Sondell (SP)	simple • SFI similar to autograft simple • CV similar to autograft	simple • Motor endplates seriously atrophied and low recovery of muscle functionality simple • Very few regenerated myelinated nerve fibers
Hudson (HP)	simple • Low percentage of chemical detergents simple • Good muscle wet weight ratio at 10–15 weeks simple • Axon diameter and myelinated sheath thickness comparable to autografts at 10–15 weeks	simple • Low CV values 10–15 weeks after repair
Neubauer (NP)	simple • Satisfying SFI simple • Satisfying muscle weight and tension ratio simple • Satisfying quantitative histomorphological parameters (myelinated fiber number, axon diameter, myelin sheath thickness)	simple • CV values halved of that registered in autografts simple • Low myelinated fiber density
Freeze-and-thaw (FTP)	simple • Quickest and less laborious protocol, no chemicals are needed	simple • Low values of SFI simple • Low myelinated fiber density simple • Cell debris are not eliminated simple • Damaged basal lamina and difficult axonal regeneration
Triton-X (AP-T)	simple • Remarkable electrophysiological outcome (considering the higher average graft length) simple • Muscle tension ratio recovery similar to autografts	simple • Long time to the decellularization process simple • Low values of SFI recovery
Triton-X + SDS (AP-TS)	simple • Good progress in nerve regeneration (large axons at 25 weeks) simple • Basal lamina preserved	simple • Few data comparable to the other protocols
Triton-X + peracetic acid (AP-TPA)	simple • Quickest protocol between in-house protocols simple • Muscle mass recovery (muscle wet weight ratio) at 8 weeks similar to autografts simple • Quantitative histomorphological parameters (myelinated fiber number, axon diameter, myelin sheath thickness) at 8 weeks comparable with those of the autograft at 10–15 weeks	simple • Only one paper describing this protocol
Wallerian degeneration (AP-W)	simple • Myelin thickness of regenerating fibers similar to autografts	simple • Longest protocol simple • Muscle wet weight ratio recovery half than autografts