Femke Mathot

10 General discussion and future perspectives 179 allografts, the angiogenic factors resulting from the interaction between MSCs (differentiated MSCs in particular) and processed nerve allografts, led to enhanced neoangiogenesis in an in vivo model. Together with multiple enhanced neurotrophic and extracellular matrix factors, the enhanced angiogenesis caused by the MSCs results in improved functional outcomes of processed nerve allografts. There were no significant differences between the functional outcomes of undifferentiated and differentiated MSCs, resulting in a preference for the use of undifferentiated MSCs due to practical benefits. The dynamic seeding technique is applicable to human MSCs and nerve graft substitutes available in clinical practice and results in an interaction between the MSCs and the extracellular matrix of the grafts. Ideally, MSC seeding with all its beneficial effects on nerve regeneration will be combined in future studies with other initiatives to improve nerve regeneration like optimization of MSC quality, immunomodulation and surgical angiogenesis.