Composite tissue transplantation: a rapidly advancing field.

Published

Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Ravindra, KV; Wu, S; Bozulic, L; Xu, H; Breidenbach, WC; Ildstad, ST

Published Date

  • June 2008

Published In

Volume / Issue

  • 40 / 5

Start / End Page

  • 1237 - 1248

PubMed ID

  • 18589081

Pubmed Central ID

  • 18589081

Electronic International Standard Serial Number (EISSN)

  • 1873-2623

International Standard Serial Number (ISSN)

  • 0041-1345

Digital Object Identifier (DOI)

  • 10.1016/j.transproceed.2008.04.003

Language

  • eng