Linda Carime Cendales
Associate Professor of Surgery
Vascularized composite allotransplantation (VCA) refers to the transplantation of multiple tissues, such as skin, muscle, tendon, nerve, and bone, as a functional unit (e.g. a hand). Several recent advances in clinical organ transplant immunosuppression and experimental VCA have now made it feasible to consider clinical VCA for functional restoration in patients with the loss of one or both hands or large tissue defects that may not be reconstructed with autologous tissue. My research facilitates the translation of VCA from the bench to the bedside.
Our group has established preclinical models to understand VCA rejection in different tissues and to use that insight to minimize immunosuppression in VCA recipients who participate in clinical trials. We also organized the first public international consensus discussions conference in VCA at the Ninth Banff Conference on Allograft Pathology in Spain in 2007 resulting in the Banff VCA 2007 classification for skin allograft pathology. Additionally, we established a VCA Consortium to enable the comprehensive analysis of samples from patients in VCA clinical trials around the country.
Based on our studies of different immunosuppressive regimens in primates, we have been the first to show that belatacept prevents rejection in VCA in primates and controls rejection in humans. We are currently investigating this approach in a clinical trial of hand transplant recipients (NCT02310867). This clinical trial aims to determine the safety and efficacy of hand transplantation as a treatment for patients with limb loss. This study will also test the efficacy of belatacept to prevent rejection of the transplanted hand.
Current Appointments & Affiliations
- Associate Professor of Surgery, Surgery, Plastic, Maxillofacial, and Oral Surgery, Surgery 2014
Contact Information
- 129 Baker House, Durham, NC 27710
- DUMC Box 3181, Durham, NC 27710
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linda.cendales@duke.edu
(919) 684-9524
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Duke Hand Transplantation Program
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Vascularized Composite Allograft Laboratory
- Background
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Education, Training, & Certifications
- Fellow, Translational Research, Emory University School of Medicine 2009 - 2011
- Senior Clinical Fellow, National Institutes of Health 2004 - 2006
- Fellow, Transplantation Surgery, National Institutes of Health 2001 - 2004
- Clinical Fellow & Senior Fellow, Hand & Microsurgery, Christine M. Kleinert Institute 1997 - 2001
- Chief Resident, Surgery, Hospital General Dr. Manuel Gea Gonzalez (Mexico) 1995 - 1996
- Internship/Junior Resident, Surgery, Hospital General Dr. Manuel Gea Gonzalez (Mexico) 1993 - 1995
- M.D., Universidad Autonoma Metropolitana (Mexico) 1992
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Duke Appointment History
- Instructor, Temporary in the Department of Surgery, Surgery, Plastic, Maxillofacial, and Oral Surgery, Surgery 2014
- Recognition
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In the News
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SEP 9, 2016 -
JUN 9, 2016 KVUE-Austin, WFMY-Greensboro -
JUN 9, 2016 The News & Observer -
APR 14, 2016 WRAL -
DEC 3, 2015 -
OCT 7, 2015 Triangle Business Journal -
OCT 6, 2015
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- Research
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Selected Grants
- Immunomodulation to Optimize Vascularized Composite Allograft Integration for Limb Loss Therapy awarded by Department of Defense 2015 - 2019
- Positioning Vascilarized Composite Allotramsplantation within the Spectrum of Transplantation awarded by Department of Defense 2014 - 2018
- Development of a Composite Tissue Allotransplantation Research Program awarded by Emory University 2014 - 2016
- Publications & Artistic Works
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Selected Publications
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Book Sections
- Otterburn, D, and Cendales, LC. "Vascularized Composite Allotransplantation." In Tissue and Cell Clinical Use: An Essential Guide, 302-311. August 2, 2012. Full Text
- Cendales, LC, Kanitakis, J, and Burns, C. "Vascularized composite allotransplantation." In Pathology of Solid Organ Transplantation, 393-399. December 1, 2011. Full Text
- Cendales, LC, Kleiner, DE, and Kirk, AD. "Translational research in composite tissue allotransplantation." In Transplantation of Composite Tissue Allografts, 43-54. January 1, 2008. Full Text
- Cendales, LK, and Kutz, JE. "Microsurgical Cross-Hand Transfer." In The Mutilated Hand, 467-470. January 1, 2005. Full Text
- Kirk, AD, Hale, DA, Ford, E, Kleiner, DE, Kampen, RL, Elster, EA, Swanson, SJ, Cendales, LC, Cropper, T, Hale, L, Jordan, S, Koussis, T, Peretti, J, Sloane, A, Salaita, C, Ring, M, Chamberlain, C, and Mannon, RB. "Solid organ transplantation at the National Institutes of Health: development of a research-based transplantation practice." 131-144. January 2005.
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Conference Papers
- Lin, L, Wang, J, Cendales, L, Kirk, A, and Brennan, T. "In Vivo Allograft Exposure to Mitochondrial DAMPs Prior to Organ Procurement Increases Graft Rejection in Mice." American Transplant Congress. Seattle, WA. June 2, 2018 - June 6, 2018.: WILEY, June 1, 2018. Link to Item
- Wainright, J, Levin, L, Cendales, L, Wholley, C, Cherikh, W, Klassen, D, and Pomahac, B. "Facial Allotransplantation: An Early Look at OPTN Data." American Transplant Congress. Seattle, WA. June 2, 2018 - June 6, 2018.: WILEY, June 1, 2018. Link to Item
- Wainright, J, Levin, L, Wholley, C, Cherikh, W, Klassen, D, and Cendales, L. "Upper Limb Transplantation in the US: An Early Look at OPTN Data." American Transplant Congress. Seattle, WA. June 2, 2018 - June 6, 2018.: WILEY, June 1, 2018. Link to Item
- Zhu, M, Samy, K, Lin, L, Wang, J, Cendales, L, Kirk, A, Barbas, A, and Brennan, T. "Donor Deficiency of RIP3 Phosphokinase Activity Shortens Cardiac Allograft Survival in the Setting of Costimulation Blockade." American Transplant Congress. Seattle, WA. June 2, 2018 - June 6, 2018.: WILEY, June 1, 2018. Link to Item
- Cendales, LC, Levine, M, Bartlett, S, Cheeseman, J, Drachenberg, CI, Hancock, WW, Joshi, M, Kirk, AD, Frank, L, Levin, S, Uluer, M, Selim, A, Song, M, Twaddell, WS, Wang, L, Wang, Z, and Barth, RN. "Skin as a harbinger of rejection of underlying structures in VCA: Concordance or discordance?." : LIPPINCOTT WILLIAMS & WILKINS, July 1, 2016. Link to Item
- Cendales, L, Levine, M, Bartlett, S, Cheeseman, J, Drachenberg, C, Hancock, W, Joshi, M, Kirk, A, Leoopardi, F, Levin, S, Uluer, M, Selim, A, Song, M, Twaddell, W, Wang, L, Wang, Z, and Barth, R. "Skin as a Harbinger of Rejection of Underlying Structures in Vascularized Composite Allografts: Concordance or Discordance?." June 2016. Link to Item
- Cheeseman, J, Joshi, M-B, Leopardi, F, Osborne, R, Conlon, D, Stempora, L, Song, M, and Cendales, L. "Vascular Composite Allotransplantation Collaborative Initiative Biobank: Bringing the Power Back to Research." June 2016. Link to Item
- Cendales, L, Bray, R, Gebel, H, Brewster, L, Elbein, R, Song, M, Parker, D, Stillman, A, Pearson, T, and Kirk, A. "Tacrolimus to Belatacept Conversion Following Hand Transplantation: A Case Report." July 15, 2014. Link to Item
- Samy, K, Freitas, A, Farris, A, Leopardi, F, Song, M, Strobert, E, Jenkins, J, Kirk, A, and Cendales, L. "Costimulation Blockade Prolongs Rejection-Free Survival of Vascularized Composite Allografts in Non-Human Primates." July 15, 2014. Link to Item
- Cendales, L, Bray, R, Gebel, H, Brewster, L, Elbein, R, Song, M, Parker, D, Stillman, A, Pearson, T, and Kirk, A. "Tacrolimus to Belatacept Conversion Following Hand Transplantation: A Case Report." June 2014. Link to Item
- Samy, K, Freitas, A, Farris, A, Leopardi, F, Song, M, Strobert, E, Jenkins, J, Kirk, A, and Cendales, L. "Costimulation Blockade Prolongs Rejection-Free Survival of Vascularized Composite Allografts in Non-Human Primates." June 2014. Link to Item
- Haas, M, Sis, B, Racusen, LC, Solez, K, Glotz, D, Colvin, RB, Castro, MCR, David, DSR, David-Neto, E, Bagnasco, SM, Cendales, LC, Cornell, LD, Demetris, AJ, Drachenberg, CB, Farver, CF, Farris, AB, Gibson, IW, Kraus, E, Liapis, H, Loupy, A, Nickeleit, V, Randhawa, P, Rodriguez, ER, Rush, D, Smith, RN, Tan, CD, Wallace, WD, Mengel, M, and Banff meeting report writing committee, . "Banff 2013 meeting report: inclusion of c4d-negative antibody-mediated rejection and antibody-associated arterial lesions." February 2014. Full Text
- Freitas, AM, Farris, AB, Leopardi, F, Song, M, Strobert, E, Kirk, AD, and Cendales, LC. "Costimulation Blockade Based Regimens Prolong Graft Survival of Vascularized Composite Allografts in Non-Human Primates." May 2012. Link to Item
- Mengel, M, Sis, B, Haas, M, Colvin, RB, Halloran, PF, Racusen, LC, Solez, K, Cendales, L, Demetris, AJ, Drachenberg, CB, Farver, CF, Rodriguez, ER, Wallace, WD, Glotz, D, and Banff meeting report writing committee, . "Banff 2011 Meeting report: new concepts in antibody-mediated rejection." March 2012. Full Text
- Freitas, AM, Page, AJ, Dai, E, Farris, AB, Leopardi, F, Song, M, Strobert, E, Kirk, AD, and Cendales, LC. "Vascularized Composite Allografts: Experience with Costimulation Blockade in Non-Human Primates." April 2011. Link to Item
- Cendales, L, Kanitakis, J, Schneeberger, S, Burns, C, Ruiz, P, Landin, L, Remmelink, M, Hewitt, C, Landgren, A, Lyons, B, Drachenberg, C, Solez, K, Kleiner, D, and Racusen, L. "The Banff composite tissue allotransplantation 2007 working classification of skin Allograft Pathology." May 2008. Link to Item
- Pearl, JP, Xu, H, Christopher, KL, Leopardi, F, Preston, E, Cendales, L, Hale, D, and Kirk, AD. "Aggressive lymphocyte depletion does not eliminate immune memory." 2004. Link to Item
- Swanson, J, Hale, D, Cendales, L, Kirk, A, and Mannon, RB. "Monitoring immunosuppression following kidney transplantation: Experience with the Cylex (TM) immune cell function assay." September 2002. Link to Item
- Cendales, L, Breidenbach, W, Granger, DK, and Jones, JW. "Evaluation of function following human hand transplantation." April 27, 2000. Link to Item
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Journal Articles
- Weissenbacher, A, Cendales, L, Morelon, E, Petruzzo, P, Brandacher, G, Friend, PJ, Gorantla, V, Kaufman, C, Krapf, J, Levin, LS, Vrakas, G, and Schneeberger, S. "Meeting Report of the 13th Congress of the International Society of Vascularized Composite Allotransplantation." Transplantation 102, no. 8 (August 2018): 1250-1252. Full Text
- Cendales, LC, Ruch, DS, Cardones, AR, Potter, G, Dooley, J, Dore, D, Orr, J, Ruskin, G, Song, M, Chen, D-F, Selim, MA, and Kirk, AD. "De novo belatacept in clinical vascularized composite allotransplantation." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons 18, no. 7 (July 2018): 1804-1809. Full Text
- Zheng, HB, Watkins, B, Tkachev, V, Yu, S, Tran, D, Furlan, S, Zeleski, K, Singh, K, Hamby, K, Hotchkiss, C, Lane, J, Gumber, S, Adams, AB, Cendales, L, Kirk, AD, Kaur, A, Blazar, BR, Larsen, CP, and Kean, LS. "The Knife's Edge of Tolerance: Inducing Stable Multilineage Mixed Chimerism but With a Significant Risk of CMV Reactivation and Disease in Rhesus Macaques." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons 17, no. 3 (March 2017): 657-670. Full Text
- Schneider, M, Cardones, ARG, Selim, MA, and Cendales, LC. "Vascularized composite allotransplantation: a closer look at the banff working classification." Transplant international : official journal of the European Society for Organ Transplantation 29, no. 6 (June 2016): 663-671. (Review) Full Text
- Cendales, L, Bray, R, Gebel, H, Brewster, L, Elbein, R, Farthing, D, Song, M, Parker, D, Stillman, A, Pearson, T, and Kirk, AD. "Tacrolimus to Belatacept Conversion Following Hand Transplantation: A Case Report." American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 15, no. 8 (August 2015): 2250-2255. Full Text
- Freitas, AM, Samy, KP, Farris, AB, Leopardi, FV, Song, M, Stempora, L, Strobert, EA, Jenkins, JA, Kirk, AD, and Cendales, LC. "Studies Introducing Costimulation Blockade for Vascularized Composite Allografts in Nonhuman Primates." American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 15, no. 8 (August 2015): 2240-2249. Full Text
- Cendales, L, Granger, D, Henry, M, Jones, J, Langnas, A, Levi, D, Magee, J, Merion, R, Olthoff, K, Pruett, T, Roberts, J, Abecassis, M, and ASTS VCA Ad Hoc Committee and Executive Committee, . "Implementation of vascularized composite allografts in the United States: recommendations from the ASTS VCA Ad Hoc Committee and the Executive Committee." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons 11, no. 1 (January 2011): 13-17. Full Text
- Cendales, L. "Animal Models in Immunology and Transplant Medicine." ILAR Journal 52, no. Suppl 1 (January 1, 2011): 498-501. Full Text
- Cendales, LC, Kanitakis, J, Schneeberger, S, Burns, C, Ruiz, P, Landin, L, Remmelink, M, Hewitt, CW, Landgren, T, Lyons, B, Drachenberg, CB, Solez, K, Kirk, AD, Kleiner, DE, and Racusen, L. "The Banff 2007 working classification of skin-containing composite tissue allograft pathology." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons 8, no. 7 (July 2008): 1396-1400. Full Text
- Cendales, LC, Kirk, AD, Moresi, JM, Ruiz, P, and Kleiner, DE. "Composite tissue allotransplantation: classification of clinical acute skin rejection." Transplantation 81, no. 3 (February 2006): 418-422. Full Text
- Cendales, LC, Xu, H, Bacher, J, Eckhaus, MA, Kleiner, DE, and Kirk, AD. "Composite tissue allotransplantation: development of a preclinical model in nonhuman primates." Transplantation 80, no. 10 (November 2005): 1447-1454. Full Text
- Kirk, AD, Mannon, RB, Kleiner, DE, Swanson, JS, Kampen, RL, Cendales, LK, Elster, EA, Wakefield, T, Chamberlain, C, Hoffmann, SC, and Hale, DA. "Results from a human renal allograft tolerance trial evaluating T-cell depletion with alemtuzumab combined with deoxyspergualin." Transplantation 80, no. 8 (October 2005): 1051-1059. Full Text
- Elster, EA, Hale, DA, Mannon, RB, Cendales, LC, Kleiner, D, Swanson, SJ, and Kirk, AD. "Surgical transplant physical examination: correlation of renal resistance index and biopsy-proven chronic allograft nephropathy." Journal of the American College of Surgeons 200, no. 4 (April 2005): 552-556. Full Text
- Hoffmann, SC, Hale, DA, Kleiner, DE, Mannon, RB, Kampen, RL, Jacobson, LM, Cendales, LC, Swanson, SJ, Becker, BN, and Kirk, AD. "Functionally significant renal allograft rejection is defined by transcriptional criteria." American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 5, no. 3 (March 2005): 573-581. Full Text
- Cendales, LC, Kirk, AD, Moresi, JM, Ruiz, P, and Kleiner, DE. "Composite tissue allotransplantation: Classification of clinical acute skin rejection." Transplantation 80, no. 12 (2005): 1676-1680. Full Text
- Elster, EA, Hale, DA, Mannon, RB, Cendales, LC, Swanson, SJ, and Kirk, AD. "The road to tolerance: renal transplant tolerance induction in nonhuman primate studies and clinical trials." Transplant immunology 13, no. 2 (September 2004): 87-99. (Review) Full Text
- Hale, DA, Swanson, S, Mannon, RB, Kleiner, DE, Hoffmann, SC, Kampen, RL, Cendales, LK, Tadaki, DK, Harlan, DM, and Kirk, AD. "Immunologic monitoring of the transplant recipient: challenges and approaches with antibody induction." Transplantation Reviews 17, no. 4 (October 2003): S20-S25. Full Text
- Kirk, AD, Hale, DA, Mannon, RB, Kleiner, DE, Hoffmann, SC, Kampen, RL, Cendales, LK, Tadaki, DK, Harlan, DM, and Swanson, SJ. "Results from a human renal allograft tolerance trial evaluating the humanized CD52-specific monoclonal antibody alemtuzumab (CAMPATH-1H)." Transplantation 76, no. 1 (July 2003): 120-129. Full Text
- Cendales, LC, Swanson, SJ, Kirk, AD, Mannon, RB, and Hale, DA. "Delayed autotransplantation of a solitary kidney facilitated by pump perfusion preservation." Surgery 133, no. 4 (April 2003): 438-439. Full Text
- Swanson, SJ, Hale, DA, Mannon, RB, Kleiner, DE, Cendales, LC, Chamberlain, CE, Polly, SM, Harlan, DM, and Kirk, AD. "Kidney transplantation with rabbit antithymocyte globulin induction and sirolimus monotherapy." Lancet (London, England) 360, no. 9346 (November 2002): 1662-1664. Full Text
- Cendales, LC, and Breidenbach, WC. "Hand transplantation." Hand clinics 17, no. 3 (August 2001): 499-x. (Review)
- Cendales, L, and Hardy, MA. "Immunologic considerations in composite tissue transplantation: overview." Microsurgery 20, no. 8 (January 2000): 412-419. (Review) Full Text
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Other Articles
- Cendales, LC, Rahmel, A, and Pruett, TL. "Allocation of vascularized composite allografts: what is it?." Transplantation 93, no. 11 (June 2012): 1086-1087. Full Text
- Pomahac, B, Becker, YT, Cendales, L, Ildstad, ST, Li, X, Schneeberger, S, Siemionow, M, Thomson, AW, Zheng, XX, and Tullius, SG. "Vascularized composite allotransplantation research: the emerging field." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons 12, no. 4 (April 2012): 1062-1063. (Letter) Full Text
- Cendales, LC. "The 10th International Hand and Composite Allotransplantation Society (IHCTAS) (vol 43, pg 3500, 2011)." TRANSPLANTATION PROCEEDINGS 44, no. 1 (2012): 309-309. Full Text Link to Item
- Cendales, LC, and Tadaki, D. "The 10th International Hand and Composite Allotransplantation Society (IHCTAS)." Transplantation Proceedings 43, no. 9 (November 2011): 3500-3500. Full Text
- Cendales, L. "The New Face of Transplant Surgery: A Survey on Cosmetic Surgery in Transplant Recipients." Aesthetic Plastic Surgery 33, no. 6 (November 2009): 827-827. Full Text
- Newell, KA, Cendales, LC, and Kirk, AD. "Finding the right job for the tool: alemtuzumab and its role in renal transplantation." American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 8, no. 7 (July 2008): 1363-1364. Full Text
- Cendales, LC, and Kirk, AD. "Nonhuman primates for the study of composite tissue allotransplantation." Transplantation 83, no. 2 (January 2007): 241-. (Letter) Full Text
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