Immunology of vascularized composite allotransplantation: a primer for hand surgeons.

Journal Article (Journal Article)

Vascularized composite allotransplantation is a recent innovation in the fields of transplantation surgery, plastic and reconstructive surgery, and orthopedic surgery. The success of hand and face transplantation has been based on extensive experience in solid organ transplantation. Advances in understanding the immunology of transplantation have had a major role in achieving excellent results in this new field. The purpose of this article is to introduce the basics of human immunology (innate and adaptive systems) and the immunological basis of human transplantation (the importance of human leukocyte antigen, direct and indirect pathways of antigen recognition, the 3 signals for T-cell activation, and mechanisms and types of allograft rejection) and focus on the mode of action of immunosuppressive drugs that have evolved as the mechanisms and pathways for rejection have been defined through research. This includes recent studies involving the use of costimulatory blockade, regulatory T cells, and tolerance induction that have resulted from research in understanding the mechanisms of immune recognition and function.

Full Text

Duke Authors

Cited Authors

  • Ravindra, K; Haeberle, M; Levin, LS; Ildstad, ST

Published Date

  • April 2012

Published In

Volume / Issue

  • 37 / 4

Start / End Page

  • 842 - 850

PubMed ID

  • 22464235

Electronic International Standard Serial Number (EISSN)

  • 1531-6564

Digital Object Identifier (DOI)

  • 10.1016/j.jhsa.2012.01.042


  • eng

Conference Location

  • United States