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Immunologic considerations in composite tissue transplantation: Overview
Author(s) -
Cendales Linda,
Hardy Mark A.
Publication year - 2000
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/1098-2752(2000)20:8<412::aid-micr12>3.0.co;2-m
Subject(s) - medicine , immunosuppression , transplantation , microsurgery , intensive care medicine , surgery , organ transplantation , immunologic tolerance , immune tolerance , immune system , immunology
Successful clinical transplantation of the upper extremity has been performed in several centers. In contrast with the recipients of other immediately vascularized organ allografts, the candidate for upper extremity transplantation has been, at least during the initial effort, a healthy patient. Although it is clear that composite tissue transplantation (CTA) is a form of allografting that behaves in many ways similarly to immediately vascularized organ allografts, the issue of developing immunologic understanding of such new allografts, awaits greater clinical experience. A summary of the immunosuppressive management of the patients who received hand allografts, with a view to explore the immunologic advantages and disadvantages as well as graft toxicity of the commonly used agents, is reported. This brief overview of the immunologic considerations in CTA is presented with the purpose of summarizing the main issues that contribute to the ultimate goal of achieving tolerance. These considerations include (1) the recipients before transplantation, (2) the donors including possible pretreatment, (3) immunosuppression for induction, maintenance, and treatment of acute rejection and its diagnosis, and (4) future potential for tolerance induction. © 2000 Wiley‐Liss, Inc. Microsurgery 20:412–419 2000