Unit:
Library of the School of Health SciencesFaculty of MedicineΠΜΣ Μοριακή και Εφαρμοσμένη Φυσιολογία
Author:
Silaidi Christina
Supervisors info:
Αλέξανδρος Παπαλάμπρος, Επίκουρος Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α., Επιβλέπων
Μιχαήλ Κοντός, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α
Μιχαήλ Κουτσιλιέρης, Καθηγητής, Ιατρική Σχολή, Ε.Κ.Π.Α
Original Title:
Vascularized Composite Allotransplantation: Current challenges and future perspectives
Translated title:
Vascularized Composite Allotransplantation: Current challenges and future perspectives.
Summary:
Vascularised composite allotransplants (VCAs) have unique properties because of diverse tissue components transplanted en mass as a single unit. Modern microsurgical techniques have made possible a broad spectrum of novel means for the reconstruction of complex bone and soft tissue defects. These techniques, in combination with developments in transplant immunology, have led to successful allotransplantation and achievement of the highest rung in the reconstructive ladder - truly replacing like with like. The utilization of contemporary microsurgical technique in the context of VCA permits successful technical execution and feasibility of VCA, facilitates the study of immunologic tolerance in VCA preclinical models, and optimizes functional VCA outcomes.
In addition to surgery, this type of transplant also faces enormous immunological challenges that demand a detailed analysis of all aspects of alloimmune responses, organ preservation, and injury, as well as the immunogenicity of various tissues within the VCA grafts to further improve graft and patient outcomes. Moreover, the side effects of long-term immunosuppression for VCA patients need to be carefully balanced with the potential benefit of a non-life-saving procedure. Vascularized Composite Allografts offer the opportunity for life-improving function to patients with tissue loss unable to be reconstructed through traditional techniques. Currently, most immunosuppressive regimens reported to date in clinical VCA have used CNIs, with most of the VCA recipients experiencing side effects. Since VCA is typically employed for non‐life‐threatening conditions, the need of a CNI-free regimen is needed. In this review article, we provide a comprehensive update with a specific emphasis on the alloimmune responses to VCA, established and novel immunosuppressive treatments, and patient outcomes.
Main subject category:
Health Sciences
Keywords:
Vascularized, Composite, Allograft, Allotransplantation
