Scholars@Duke
Linda Carime Cendales

Linda Carime Cendales

Professor of Surgery
Surgery, Plastic, Maxillofacial, and Oral Surgery
linda.cendales@duke.edu
DUMC Box 3181, Durham, NC 27710
129 Baker House, Durham, NC 27710

Selected Publications

Changes in functional and structural brain connectivity following bilateral hand transplantation

Journal Article NeuroImage: Reports · December 1, 2024 As a surgical treatment following amputation or loss of an upper limb, nearly 200 hand transplantations have been completed to date. We report here a magnetic resonance imaging (MRI) investigation of functional and structural brain connectivity for a bilat ... Full text Cite

Vascular changes in vascularized composite allotransplantation.

Journal Article Curr Opin Organ Transplant · December 1, 2024 PURPOSE OF REVIEW: Allograft vasculopathy in vascularized composite allografts (VCA) remains understudied. This review explores the vascular changes in VCA, focused on recent literature. RECENT FINDINGS: Allograft vasculopathy in VCA generally includes pro ... Full text Link to item Cite

Banff 2022 Vascularized Composite Allotransplantation Meeting Report: Diagnostic criteria for vascular changes.

Journal Article Am J Transplant · May 2024 As more data become available, the Banff 2007 working classification of skin-containing vascularized composite allograft (VCA) pathology is expected to evolve and develop. This report represents the Banff VCA Working Group's consensus on the first revision ... Full text Link to item Cite

OPTN/SRTR 2022 Annual Data Report: Vascularized Composite Allograft.

Journal Article Am J Transplant · February 2024 This year's chapter on vascularized composite allograft (VCA) encompasses reviews of data collected from 2014 (when VCA was included in the Final Rule) through 2022. The present Annual Data Report shows that the number of VCA recipients in the United State ... Full text Link to item Cite

American Society of Transplant Surgeons-American Society of Transplantation report of FDA meeting on regulatory expectations for xenotransplantation products.

Journal Article Am J Transplant · September 2023 In June 2022, the US Food and Drug Administration Center for Biologics Evaluation and Research held the 73rd meeting of the Cellular, Tissue, and Gene Therapies Advisory Committee for public discussion of regulatory expectations for xenotransplantation pro ... Full text Link to item Cite

OPTN/SRTR 2021 Annual Data Report: Vascularized Composite Allograft.

Journal Article Am J Transplant · February 2023 Year 2020 marked the first OPTN/SRTR Annual Data Report that included a chapter on vascularized composite allograft (VCA), which encompassed reviews of data collected between 2014 (when VCA was included in the Final Rule) and 2020. The present Annual Data ... Full text Link to item Cite

OPTN/SRTR 2020 Annual Data Report: VCA.

Journal Article Am J Transplant · March 2022 The first vascularized composite allograft (VCA) transplant in the United States was performed in 1998 in a 40-year-old man who received a laryn-geal transplant after experiencing severe trauma to the throat 20 years before. The following VCA was a hand tr ... Full text Link to item Cite

Plastic Surgery Diversity through the Decade: Where We Stand and How We Can Improve

Journal Article Plastic and Reconstructive Surgery - Global Open · February 22, 2022 Background: Several studies over the past decade have investigated diversity within the field of plastic surgery, yet it remains unclear if an increase has resulted. This study sought to review the status of diversity within plastic surgery over the last d ... Full text Cite

Advanced Amputation Techniques in Orthopedic Surgery: Hand Transplantation

Journal Article Techniques in Orthopaedics · December 8, 2021 Hand transplantation is a form of vascularized composite allotransplantation under clinical research, which presents a novel therapy to amputation. Preparation for hand transplantation requires a carefully selected candidate, an extensive preoperative work ... Full text Cite

Psychosocial considerations in the assessment of hand transplant candidates: A single-center experience and brief literature review.

Journal Article Clin Transplant · April 2021 Vascularized composite allograft, including hand transplantation (HT), has gained wider usage as a reconstructive treatment over the past 30 years. HT recipients face unique psychosocial challenges compared to their solid organ and/or bone marrow transplan ... Full text Link to item Cite

Vascularized composite allotransplants as a mechanistic model for allograft rejection - an experimental study.

Journal Article Transpl Int · March 2021 Vascularized composite allotransplants (VCAs) seem to have several unique features of clinical and experimental importance, including uniquely definable lymphatic drainage that can be easily accessed at the level of ipsilateral regional node beds. Thus, VC ... Full text Link to item Cite

The Legacy of Joseph A. Moylan, M.D.: "It's About Everyone Else".

Journal Article Ann Surg Open · March 2021 The history of modern American surgery is marked by larger-than-life pioneers who have made transformative contributions to our field. These extraordinary individuals have been known primarily for their technical and clinical mastery, development of novel ... Full text Link to item Cite

Vascularized composite allotransplantation in the United States: A retrospective analysis of the Organ Procurement and Transplantation Network data after 5 years of the Final Rule.

Journal Article Am J Transplant · January 2021 On July 3, 2014, the Organ Procurement and Transplantation Network (OPTN) began overseeing vascularized composite allotransplantation/allografts (VCA) in the United States. For the past 6 years, centers performing VCAs have been requested to submit data in ... Full text Open Access Link to item Cite

Sensitization and Desensitization in Vascularized Composite Allotransplantation.

Journal Article Front Immunol · 2021 Vascularized composite allotransplantation (VCA) is a field under research and has emerged as an alternative option for the repair of severe disfiguring defects that result from severe tissue loss in a selected group of patients. Lifelong immunosuppressive ... Full text Open Access Link to item Cite

Vascular Composite Allografts (VCA): New Transplants, New Infections

Chapter · January 1, 2021 Vascularized composite allografts, or VCA transplants, are allotransplants that incorporate multiple tissues transplanted as a single functional unit, most commonly hands or face. They are, by definition, transplants aimed at improving quality of life rath ... Full text Cite

Introducing a novel experimental model of bladder transplantation in mice.

Journal Article Am J Transplant · December 2020 Bladder dysfunction is a common clinical problem attributed to various conditions such as posterior urethral valves, neurogenic bladder, ureteral ectopy, or bladder exstrophy. Currently, the main therapeutic option for these dysfunctions is neobladder reco ... Full text Link to item Cite

Th17 cell inhibition in a costimulation blockade-based regimen for vascularized composite allotransplantation using a nonhuman primate model.

Journal Article Transpl Int · October 2020 Vascularized composite allotransplantation (VCA) is challenged by the morbidity of immunosuppression required to prevent rejection. The use of highly specific biologics has not been well explored in VCA. Given that psoriasis is T-cell mediated, as is rejec ... Full text Link to item Cite

Vascularized Composite Allotransplantation: A Functional Hind Limb Model in Mice.

Journal Article J Surg Res · June 2020 BACKGROUND: Vascularized composite allograft has emerged as a reconstructive option for patients who have suffered severe tissue loss. Animal models are critical for understanding the unique mechanisms of rejection in vascularized composite allograft. We p ... Full text Link to item Cite

Hand transplantation in the United States: A review of the Organ Procurement and Transplantation Network/United Network for Organ Sharing Database.

Journal Article Am J Transplant · May 2020 Hand transplantation is the most common application of vascularized composite allotransplantation (VCA). Since July 3, 2014, VCAs were added to the definition of organs covered by federal regulation (the Organ Procurement and Transplantation Network (OPTN) ... Full text Link to item Cite

Defining chronic rejection in vascularized composite allotransplantation-The American Society of Reconstructive Transplantation and International Society of Vascularized Composite Allotransplantation chronic rejection working group: 2018 American Society of Reconstructive Transplantation meeting report and white paper Research goals in defining chronic rejection in vascularized composite allotransplantation.

Journal Article SAGE Open Med · 2020 OBJECTIVES: This report summarizes a collaborative effort between the American Society of Reconstructive Transplantation and the International Society of Vascularized Composite Allotransplantation to establish what is known about chronic rejection in recip ... Full text Open Access Link to item Cite

Costimulation Blockade in Vascularized Composite Allotransplantation.

Journal Article Front Immunol · 2020 Vascular composite allotransplantation (VCA) is a field under research and has emerged as an alternative option for the repair of severe disfiguring defects that result from infections or traumatic amputation in a selected group of patients. VCA is perform ... Full text Open Access Link to item Cite

Neural activation for actual and imagined movement following unilateral hand transplantation: a case study.

Journal Article Neurocase · December 2019 Transplantation of a donor hand has been successful as a surgical treatment following amputation, but little is known regarding the brain mechanisms contributing to the recovery of motor function. We report functional magnetic resonance imaging (fMRI) find ... Full text Open Access Link to item Cite

Psychosocial dimensions of hand transplantation: lessons learned from solid organ transplantation.

Journal Article Curr Opin Organ Transplant · December 2019 PURPOSE OF REVIEW: The present review examines psychosocial factors emerging as predictive of clinical outcomes among solid organ transplant (SOT) recipients, with possible extensions to vascular composite allograft (VCA) and hand transplantation, in parti ... Full text Link to item Cite

Small bowel and abdominal wall transplantation: A novel technique for synchronous revascularization.

Journal Article Am J Transplant · July 2019 Abdominal wall transplantation (AWT) was introduced in 1999 in the context of reconstruction of complex abdominal wall defects in conjunction with visceral organ transplantation. As of recently, 38 cases of total AWT have been performed worldwide, about ha ... Full text Link to item Cite

Infections after upper extremity allotransplantation: a worldwide population cohort study, 1998-2017.

Journal Article Transpl Int · July 2019 Risk-to-benefit analysis of upper extremity allotransplantation (UEA) warrants a careful assessment of immunosuppression-related complications. This first systematic report of infectious complications after UEA aimed to compare incidence and pattern of inf ... Full text Link to item Cite

Vascularized composite allotransplantation in the United States: A descriptive analysis of the Organ Procurement and Transplantation Network Data.

Journal Article Am J Transplant · March 2019 On July 3, 2014, the Organ Procurement and Transplantation Network/United Network for Organ Sharing was charged with the oversight of vascularized composite allograft (VCA) procurement and transplantation in the United States. As of December 31, 2017, 61 V ... Full text Link to item Cite

Current opinions in organ allocation.

Journal Article Am J Transplant · November 2018 Existing methods of academic publication provide limited opportunity to obtain stakeholder input on issues of broad interest. This article reports the results of an experiment to produce a collaborative, crowdsourced article examining a current controversi ... Full text Link to item Cite

Meeting Report of the 13th Congress of the International Society of Vascularized Composite Allotransplantation.

Journal Article Transplantation · August 2018 The International Society of Vascularized Composite Allotransplantation held its 13th congress "Defining Success" in October 2017 in Salzburg, Austria. A total of 122 delegates from 22 countries representing 5 continents attended the conference. The theme ... Full text Link to item Cite

De novo belatacept in clinical vascularized composite allotransplantation.

Journal Article Am J Transplant · July 2018 Most immunosuppressive regimens used in clinical vascularized composite allotransplantation (VCA) have been calcineurin inhibitor (CNI)-based. As such, most recipients have experienced CNI-related side effects. Costimulation blockade, specifically CD28/B7 ... Full text Link to item Cite

Upper Limb Transplantation in the US: An Early Look at OPTN Data.

Conference AMERICAN JOURNAL OF TRANSPLANTATION · June 1, 2018 Link to item Cite

Facial Allotransplantation: An Early Look at OPTN Data.

Conference AMERICAN JOURNAL OF TRANSPLANTATION · June 1, 2018 Link to item Cite

The Knife's Edge of Tolerance: Inducing Stable Multilineage Mixed Chimerism but With a Significant Risk of CMV Reactivation and Disease in Rhesus Macaques.

Journal Article Am J Transplant · March 2017 Although stable mixed-hematopoietic chimerism induces robust immune tolerance to solid organ allografts in mice, the translation of this strategy to large animal models and to patients has been challenging. We have previously shown that in MHC-matched nonh ... Full text Link to item Cite

Vascularized composite allotransplantation: a closer look at the banff working classification.

Journal Article Transpl Int · June 2016 The first Banff vascularized composite allotransplantation meeting was held in 2007 to standardize criteria for the characterization and reporting of severity and types of rejection. As a result, the 2007 Banff VCA working classification for skin allograft ... Full text Link to item Cite

Tacrolimus to Belatacept Conversion Following Hand Transplantation: A Case Report.

Journal Article Am J Transplant · August 2015 Featured Publication Vascularized composite allotransplantation (VCA) has emerged as a viable limb replacement strategy for selected patients with upper limb amputation. However, allograft rejection has been seen in essentially all reported VCA recipients indicating a requirem ... Full text Link to item Cite

Studies Introducing Costimulation Blockade for Vascularized Composite Allografts in Nonhuman Primates.

Journal Article Am J Transplant · August 2015 Featured Publication Vascularized composite allografts (VCAs) are technically feasible. Similar to other organ transplants, VCAs are hampered by the toxicity and incomplete efficacy associated with conventional immunosuppression. Complications attributable to calcineurin inhib ... Full text Link to item Cite

Tacrolimus to Belatacept Conversion Following Hand Transplantation: A Case Report.

Conference AMERICAN JOURNAL OF TRANSPLANTATION · June 1, 2014 Link to item Cite

Banff 2013 meeting report: inclusion of c4d-negative antibody-mediated rejection and antibody-associated arterial lesions.

Conference Am J Transplant · February 2014 The 12th Banff Conference on Allograft Pathology was held in Comandatuba, Brazil, from August 19-23, 2013, and was preceded by a 2-day Latin American Symposium on Transplant Immunobiology and Immunopathology. The meeting was highlighted by the presentation ... Full text Link to item Cite

Vascularized Composite Allotransplantation

Chapter · August 2, 2012 Organ transplantation has proven to provide curative treatment for most end stage solid organ diseases. Given this success, transplantation therapies have been proposed for certain tissues and functions lost due to trauma or that arise from congenital anom ... Full text Cite

Allocation of vascularized composite allografts: what is it?

Other Transplantation · June 15, 2012 Featured Publication To date, there are more than 80 reports of vascularized composite allografts (VCAs; a.k.a. composite tissue allotransplantation). However, the classification of this type of transplantation for oversight purposes has not been clarified. From a biological a ... Full text Link to item Cite

Banff 2011 Meeting report: new concepts in antibody-mediated rejection.

Conference Am J Transplant · March 2012 The 11th Banff meeting was held in Paris, France, from June 5 to 10, 2011, with a focus on refining diagnostic criteria for antibody-mediated rejection (ABMR). The major outcome was the acknowledgment of C4d-negative ABMR in kidney transplants. Diagnostic ... Full text Link to item Cite

Erratum

Other Transplantation Proceedings · January 2012 Featured Publication Full text Cite

Vascularized composite allotransplantation

Chapter · December 1, 2011 Vascularized composite allotransplantation is a field in its early development. This chapter describes the latest classification scheme applied to composite grafts and acute cellular rejection is amply demonstrated with high quality images. The differentia ... Full text Cite

The 10th international hand and composite allotransplantation society (IHCTAS)

Other Transplantation Proceedings · November 1, 2011 Featured Publication Full text Cite

Implementation of vascularized composite allografts in the United States: recommendations from the ASTS VCA Ad Hoc Committee and the Executive Committee.

Journal Article Am J Transplant · January 2011 Featured Publication Like all other areas of transplantation, vascularized composite allografts (VCA) has the capacity to transform the lives of patients, for the better or for the worse. It is this duality that mandates VCA be performed in centers prepared for the intricacies ... Full text Link to item Cite

Animal Models in Immunology and Transplant Medicine

Journal Article ILAR Journal · January 1, 2011 Featured Publication Full text Cite

The new face of transplant surgery: A survey on cosmetic surgery in transplant recipients

Other Aesthetic Plastic Surgery · November 1, 2009 Featured Publication Full text Cite

The Banff 2007 working classification of skin-containing composite tissue allograft pathology.

Journal Article Am J Transplant · July 2008 Featured Publication Composite tissue allotransplantation (CTA) is a recently introduced option for limb replacement and reconstruction of tissue defects. As with other allografts, CTA can undergo immune-mediated rejection; therefore standardized criteria are required for char ... Full text Link to item Cite

Translational research in composite tissue allotransplantation

Chapter · January 1, 2008 Featured Publication Patients suffering from severe tissue loss secondary to burns, traumatic injuries, or tumor resections have limited options for reconstruction when autologous tissue for reconstruction is scarce. Composite tissue allotransplantation (CTA) has recently been ... Full text Cite

Nonhuman primates for the study of composite tissue allotransplantation.

Other Transplantation · January 27, 2007 Featured Publication Full text Link to item Cite

Composite tissue allotransplantation: classification of clinical acute skin rejection.

Journal Article Transplantation · February 15, 2006 Featured Publication BACKGROUND: Composite tissue allotransplantation (CTA) is a recently introduced option for limb replacement and reconstruction of other nonreconstructible tissue defects. As with recipients of other allotransplants, CTA recipients can experience rejection ... Full text Link to item Cite

Composite tissue allotransplantation: classification of clinical acute skin rejection.

Journal Article Transplantation · December 27, 2005 BACKGROUND: Composite tissue allotransplantation (CTA) is a recently introduced option for limb replacement and reconstruction of other nonreconstructible tissue defects. As with recipients of other allotransplants, CTA recipients can experience rejection ... Link to item Cite

Composite tissue allotransplantation: development of a preclinical model in nonhuman primates.

Journal Article Transplantation · November 27, 2005 Featured Publication BACKGROUND: Composite tissue allotransplantation (CTA) has been recently introduced as a potential treatment for tissue loss secondary to burns, injuries, or resections. However, the optimal strategies to prevent CTA rejection remain undefined. Presently, ... Full text Link to item Cite

Results from a human renal allograft tolerance trial evaluating T-cell depletion with alemtuzumab combined with deoxyspergualin.

Journal Article Transplantation · October 27, 2005 Featured Publication BACKGROUND: Perioperative lymphocyte depletion induces allograft tolerance in some animal models, but in humans has only been shown to reduce immunosuppressive requirements. Without maintenance immunosuppression, depleted human renal allograft recipients e ... Full text Link to item Cite

Surgical transplant physical examination: correlation of renal resistance index and biopsy-proven chronic allograft nephropathy.

Journal Article J Am Coll Surg · April 2005 Featured Publication BACKGROUND: Chronic allograft nephropathy (CAN) remains the leading cause of late renal allograft loss that is minimally responsive to therapy once graft dysfunction is clinically evident. A screening test capable of identifying individuals at high risk fo ... Full text Link to item Cite

Functionally significant renal allograft rejection is defined by transcriptional criteria.

Journal Article Am J Transplant · March 2005 Featured Publication Renal allograft acute cellular rejection (ACR) is a T-cell mediated disease that is diagnosed histologically. However, many normally functioning allografts have T-cell infiltrates and histological ACR, and many nonimmune processes cause allograft dysfuncti ... Full text Link to item Cite

Solid organ transplantation at the National Institutes of Health: development of a research-based transplantation practice.

Chapter · 2005 Featured Publication The National Institutes of Health has established a clinical transplant research program focusing on translational research in kidney transplantation. The program has been developed with a multidisciplinary approach under a common administrative structure ... Link to item Cite

The road to tolerance: renal transplant tolerance induction in nonhuman primate studies and clinical trials.

Journal Article Transpl Immunol · 2004 Featured Publication Organ transplantation has become a standard life-saving therapy for many causes of end stage organ failure. Although valuable, it remains hampered by the requirement for, and complications of, immunosuppression to prevent immune rejection of the transplant ... Full text Link to item Cite

Aggressive lymphocyte depletion does not eliminate immune memory.

Conference AMERICAN JOURNAL OF TRANSPLANTATION · January 1, 2004 Link to item Cite

Composite tissue allotransplantation: Development of a non-human primate model

Conference AMERICAN JOURNAL OF TRANSPLANTATION · January 1, 2004 Link to item Cite

Characterization of human and non-human primate composite tissue allograft rejection

Conference AMERICAN JOURNAL OF TRANSPLANTATION · January 1, 2004 Link to item Cite

Results from a human renal allograft tolerance trial evaluating the humanized CD52-specific monoclonal antibody alemtuzumab (CAMPATH-1H).

Journal Article Transplantation · July 15, 2003 Featured Publication BACKGROUND: Profound T-cell depletion before allotransplantation with gradual posttransplant T-cell repopulation induces a state of donor-specific immune hyporesponsiveness or tolerance in some animal models. Alemtuzumab (Campath-1H, Millennium Pharmaceuti ... Full text Link to item Cite

Immunologic monitoring of the transplant recipient: Challenges and approaches with antibody induction

Journal Article Transplantation Reviews · 2003 Featured Publication In summary, the results from these studies suggest that, in addition to their typical roles as antigen-processing cells serving to initiate an adaptive immune response, monocytes and macrophages may also play an effector role during rejection in patients w ... Full text Link to item Cite

Kidney transplantation with rabbit antithymocyte globulin induction and sirolimus monotherapy.

Journal Article Lancet · November 23, 2002 Featured Publication Renal allograft recipients generally need to take several immunosuppressive agents for life. Calcineurin inhibitors and glucocorticosteroids are the mainstays of most regimens but have undesirable chronic effects. We postulated that aggressive T-cell deple ... Full text Link to item Cite

Monitoring immunosuppression following kidney transplantation: Experience with the Cylex (TM) immune cell function assay

Conference JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY · September 1, 2002 Featured Publication Link to item Cite

Hand transplantation.

Journal Article Hand Clin · August 2001 The surgical techniques necessary to perform hand transplantation have been available for at least 25 years. In this article, the authors provide a review of hand transplantation, including its history, preoperative evaluation, and case reports. Data on tr ... Link to item Cite

Evaluation of function following human hand transplantation.

Conference TRANSPLANTATION · April 27, 2000 Featured Publication Link to item Cite

Immunologic considerations in composite tissue transplantation: overview.

Journal Article Microsurgery · 2000 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 durin ... Full text Link to item Cite