TY - JOUR
T1 - Composite Tissue Transplantation
T2 - A Rapidly Advancing Field
AU - Ravindra, K. V.
AU - Wu, S.
AU - Bozulic, L.
AU - Xu, H.
AU - Breidenbach, W. C.
AU - Ildstad, S. T.
PY - 2008/6
Y1 - 2008/6
N2 - Composite tissue allotransplantation (CTA) is emerging as a potential treatment for complex tissue defects. It is currently being performed with increasing frequency in the clinic. The feasibility of the procedure has been confirmed through 30 hand transplantation, 3 facial reconstructions, and vascularized knee, esophageal, and tracheal allografts. A major drawback for CTA is the requirement for lifelong immunosuppression. The toxicity of these agents has limited the widespread application of CTA. Methods to reduce or eliminate the requirement for immunosuppression and promote CTA acceptance would represent a significant step forward in the field. Multiple studies suggest that mixed chimerism established by bone marrow transplantation promotes tolerance resulting in allograft acceptance. This overview focuses on the history and the exponentially expanding applications of the new frontier in CTA transplantation: immunology associated with CTA; preclinical animal models of CTA; clinical experience with CTA; and advances in mixed chimerism-induced tolerance in CTA. Additionally, some important hurdles that must be overcome in using bone marrow chimerism to induce tolerance to CTA are also discussed.
AB - Composite tissue allotransplantation (CTA) is emerging as a potential treatment for complex tissue defects. It is currently being performed with increasing frequency in the clinic. The feasibility of the procedure has been confirmed through 30 hand transplantation, 3 facial reconstructions, and vascularized knee, esophageal, and tracheal allografts. A major drawback for CTA is the requirement for lifelong immunosuppression. The toxicity of these agents has limited the widespread application of CTA. Methods to reduce or eliminate the requirement for immunosuppression and promote CTA acceptance would represent a significant step forward in the field. Multiple studies suggest that mixed chimerism established by bone marrow transplantation promotes tolerance resulting in allograft acceptance. This overview focuses on the history and the exponentially expanding applications of the new frontier in CTA transplantation: immunology associated with CTA; preclinical animal models of CTA; clinical experience with CTA; and advances in mixed chimerism-induced tolerance in CTA. Additionally, some important hurdles that must be overcome in using bone marrow chimerism to induce tolerance to CTA are also discussed.
UR - http://www.scopus.com/inward/record.url?scp=45449098695&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=45449098695&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2008.04.003
DO - 10.1016/j.transproceed.2008.04.003
M3 - Article
C2 - 18589081
AN - SCOPUS:45449098695
VL - 40
SP - 1237
EP - 1248
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 5
ER -