Composite Tissue Transplantation: A Rapidly Advancing Field

K. V. Ravindra, S. Wu, L. Bozulic, H. Xu, Warren C Breidenbach, S. T. Ildstad

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1237-1248
Number of pages12
JournalTransplantation Proceedings
Volume40
Issue number5
DOIs
StatePublished - Jun 2008
Externally publishedYes

Fingerprint

Vascularized Composite Allotransplantation
Tissue Transplantation
Chimerism
Immunosuppression
Allografts
Hand Transplantation
Transplantation Immunology
Transplantation Tolerance
Bone Marrow Transplantation
Knee

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Composite Tissue Transplantation : A Rapidly Advancing Field. / Ravindra, K. V.; Wu, S.; Bozulic, L.; Xu, H.; Breidenbach, Warren C; Ildstad, S. T.

In: Transplantation Proceedings, Vol. 40, No. 5, 06.2008, p. 1237-1248.

Research output: Contribution to journalArticle

Ravindra, K. V. ; Wu, S. ; Bozulic, L. ; Xu, H. ; Breidenbach, Warren C ; Ildstad, S. T. / Composite Tissue Transplantation : A Rapidly Advancing Field. In: Transplantation Proceedings. 2008 ; Vol. 40, No. 5. pp. 1237-1248.
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