Nerve grafting (nerve transplant)

Nerve grafting, also known as a nerve transplant, is a surgical procedure used to repair peripheral nerve injuries. The peripheral nervous system controls your body’s motor coordination, movement, and sensations. If these nerves get damaged, nerve grafting may be needed to help heal them. Nerve grafting is commonly used to repair nerve injuries from trauma, such as a deep cut or crushed nerve. It’s also used to repair nerves that have been intentionally cut, such as during certain surgeries.

There are two types of nerve grafts: 

• Autograft: A section of a healthy nerve is taken from one part of your body and transplanted to the area where a nerve has been damaged or is missing. The donor nerve is taken from a sensory nerve where sensation isn’t essential for day-to-day activities.
• Allograft: A section of nerve is taken from a cadaver, processed and sterilized, then transplanted to the area of your body where a nerve has been damaged or is missing.

Nerve transplant surgery is done by a nerve specialist. When preparing for nerve grafting, our nerve specialists carefully consider factors that will give you the best possible outcome. These factors include the length of the nerve gap, the type of injury, and when the injury occurred. Using the latest technology and up-to-date surgical approaches, we’re dedicated to relieving your symptoms and improving your quality of life. 

Your Penn Medicine provider may recommend nerve grafting surgery to fix several types of peripheral nerve injuries. Nerve transplant surgery is typically recommended for:

• Conditions that cause facial paralysis
• Nerve tumors and cancers
• Older nerve injuries that left scarring
• Severe nerve injuries, such as in the brachial plexus, which is a network of nerves that control movement and feeling in the arm 

Before your nerve grafting surgery, your doctor will explain how the procedure is done and give you time to ask questions. Your care team will review your medications with you, discuss your health history, and let you know how to prepare for surgery. In addition, you can expect the following:  

• Your surgery will be done at a hospital or surgery center.
• You’ll have anesthesia with sedation, so you’re asleep and pain-free during surgery.
• If your surgeon is using a nerve from another part of your body, they’ll mark the path of that nerve.
• The surgeon will make incisions in your skin to access the nerves involved.
• The surgeon will remove a piece of the donor nerve or use the cadaver nerve to place it into nearby muscles of the injured nerve. Before attaching the graft, the surgeon will remove a section of the injured or scarred nerve tissue to allow for a clean attachment.
• After the surgery, you’ll be monitored closely as you wake up from anesthesia. Most patients are discharged from the hospital the same day or the day after nerve graft surgery.
• You may experience some discomfort or pain at the surgical site, which can be managed with medication prescribed by your Penn Medicine team. 

Recovery from nerve transplant surgery can take several months. Once your body heals from surgery, your nerves take time to regrow. Many patients go to physical and occupational therapy to help regain strength and function in the affected area. Some patients may need to make temporary lifestyle changes, such as modifying certain physical activities, to avoid injuring the nerves at the surgical site. Our care team will provide you with detailed instructions to improve your recovery.

It’s important to follow your provider’s recommendations and attend follow-up appointments to monitor your progress and address any concerns during the healing process.