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Vascularized composite allotransplantation

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https://www.readbyqxmd.com/read/27893612/the-influence-of-timing-and-frequency-of-adipose-derived-mesenchymal-stem-cell-therapy-on-immunomodulation-outcomes-after-vascularized-composite-allotransplantation
#1
Jan A Plock, Jonas T Schnider, Riccardo Schweizer, Wensheng Zhang, Wakako Tsuji, Matthias Waldner, Mario G Solari, Kacey G Marra, J Peter Rubin, Vijay S Gorantla
BACKGROUND: Cellular therapies for immunomodulation in vascularized composite allotransplantation (VCA) have gained importance due to their potential minimization of immunosuppression. Adipose-derived mesenchymal stem cells (AD-MSCs) especially have shown encouraging potential. We investigated the influence of timing and frequency of AD-MSC-treatment on immunologic and graft survival as well as graft vasculopathy (GV) outcomes after VCA. METHODS: Lewis (LEW) rats received full-mismatched Brown Norway (BN) rat hindlimb transplants...
November 23, 2016: Transplantation
https://www.readbyqxmd.com/read/27879599/total-human-eye-allotransplantation-developing-surgical-protocols-for-donor-and-recipient-procedures
#2
Edward H Davidson, Eric W Wang, Jenny Y Yu, Juan C Fernandez-Miranda, Dawn J Wang, Nikisha Richards, Maxine Miller, Joel S Schuman, Kia M Washington
BACKGROUND: Vascularized composite allotransplantation of the eye is an appealing, novel method for reconstruction of the nonfunctioning eye. The authors' group has established the first orthotopic model for eye transplantation in the rat. With advancements in immunomodulation strategies together with new therapies in neuroregeneration, parallel development of human surgical protocols is vital for ensuring momentum toward eye transplantation in actual patients. METHODS: Cadaveric donor tissue harvest (n = 8) was performed with orbital exenteration, combined open craniotomy, and endonasal approach to ligate the ophthalmic artery with a cuff of paraclival internal carotid artery, for transection of the optic nerve at the optic chiasm and transection of cranial nerves III to VI and the superior ophthalmic vein at the cavernous sinus...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27879593/triptolide-reduces-the-required-dose-of-tacrolimus-by-attenuating-inflammation-enhancing-immunosuppression-and-increasing-donor-chimerism-in-a-heterotopic-hindlimb-transplantation-model
#3
Chuan Gu, Fei Liu, Xusong Luo, Xianyu Zhou, Jun Yang, L Scott Levin
BACKGROUND: Induction of tolerance and minimizing the toxicity of immunosuppression are two fundamental goals in vascularized composite allotransplantation. Accumulating data indicate that triptolide is an agent that may have the capacity to suppress inflammation and immunologic rejection. METHODS: A heterotopic hindlimb allotransplantation model from Brown Norway to Lewis rats was established and treated with different doses of tacrolimus combined with or without triptolide...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27859595/recipient-bone-marrow-derived-stromal-cells-prolong-graft-survival-in-a-rat-hind-limb-allotransplantation-model
#4
Ryosuke Ikeguchi, Ryosuke Kakinoki, Souichi Ohta, Hiroki Oda, Hirofumi Yurie, Yukitoshi Kaizawa, Hiroto Mitsui, Tomoki Aoyama, Junya Toguchida, Shuichi Matsuda
BACKGROUND: Recent studies have indicated that bone marrow-derived stromal cells (BMSCs) have immunomodulatory properties that suppress the T cell responses that cause graft rejection. The purpose of this study is to evaluate the effect of recipient BMSCs intravenous infusion for immunomodulation in a rat vascularized composite allotransplantation model. METHODS: A total of nine Wistar (WIS) rats and thirty Lewis (LEW) rats were used. BMSCs were harvested from three LEW rats...
November 17, 2016: Microsurgery
https://www.readbyqxmd.com/read/27826601/plasma-micrornas-are-potential-biomarkers-of-acute-rejection-after-hindlimb-transplantation-in-rats
#5
Hiroki Oda, Ryosuke Ikeguchi, Hirofumi Yurie, Yukitoshi Kaizawa, Souichi Ohta, Koji Yamamoto, Tomoki Aoyama, Shuichi Matsuda
BACKGROUND: The development of effective immunosuppressive regimens has resulted in many cases of successful hand transplantation. Visual skin inspection and histological evaluation are used to assess the rejection of hand transplants, but these methods are largely subjective. In this study, we aimed to determine the potential of microRNAs (miRNAs) as biomarkers for acute rejection in vascularized composite allotransplants. METHODS: In allograft group, 7 male Brown-Norway rats (RT1(n)) were used as donors and 13 male Lewis rats (RT1(l)) were used as recipients...
November 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27822384/immunomodulatory-role-of-mesenchymal-stem-cell-therapy-in-vascularized-composite-allotransplantation
#6
REVIEW
Richard Heyes, Andrew Iarocci, Yourka Tchoukalova, David G Lott
This review aims to summarize contemporary evidence of the in vitro and in vivo immunomodulatory effects of mesenchymal stem cells (MSCs) in promoting vascularized composite allotransplant (VCA) tolerance. An extensive literature review was performed to identify pertinent articles of merit. Prospective preclinical trials in mammal subjects receiving VCA (or skin allograft) with administration of MSCs were reviewed. Prospective clinical trials with intravascular delivery of MSCs in human populations undergoing solid organ transplant were also identified and reviewed...
2016: Journal of Transplantation
https://www.readbyqxmd.com/read/27801681/immunological-effect-of-skin-allograft-in-burn-treatment-impact-on-future-vascularized-composite-allotransplantation
#7
Rebecca M Garza, Barry H Press, Dolly B Tyan, Yvonne L Karanas, Gordon K Lee
Skin allografts are the benchmark in temporary burn wound coverage, but allografts are hypothesized to place a high antigenic load on recipients. This project aims to determine the degree of human leukocyte antigen sensitization in burn patients treated with allografts. Serum was obtained from nine adult, nontransfused, and nontransplanted burn patients treated with allografts. Group 1 included patients tested in the acute burn period, while group 2 included different patients tested months to years after injury...
October 27, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27755395/an-anatomical-murine-model-of-heterotopic-periorbital-subunit-transplantation
#8
Bowen Gao, Qingxiong Yu, Feng Xie, Lingling Sheng, Xiyuan Mao, Qingfeng Li, Hainan Zhu
BACKGROUND: Conventional reconstructive methods fail to achieve satisfactory results in total eyelid defect cases. Vascularized composite tissue allotransplantation might provide both good appearance and function for these patients. The structure of the eyelid is exceptional because it simultaneously consists of skin, connective tissue, the striated muscle, fiber structure, aponeuroses, and mucosa. Thus, before clinical application of eyelid allotransplantation, more experiments are needed to clarify the impact of ischemia, immunal suppressive agents, and deinnervation effects on these sophisticated structures...
October 13, 2016: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27741042/immunomodulation-by-mesenchymal-stem-cells-lessons-from-vascularized-composite-allotransplantation
#9
Martin J Hoogduijn
No abstract text is available yet for this article.
October 12, 2016: Transplantation
https://www.readbyqxmd.com/read/27740465/perioperative-management-of-a-bilateral-forearm-allograft
#10
M Clerc, J Prothet, T Rimmelé
Composite tissue allotransplantation (CTA) is a complex procedure requiring a multidisciplinary collaboration between surgeons, anesthetists, and transplantation specialists. We will describe the perioperative management of a bilateral forearm allograft performed at our facility. A 40-year-old man who lost both forearms was registered on the transplant waiting list; a suitable graft was available 11months later. Anesthesia required planning for vascular access, hemodynamic monitoring, fluid therapy management and prevention of deep vein thrombosis...
June 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27638100/technology-and-vascularized-composite-allotransplantation-vca-lessons-learned-from-the-first-bilateral-pediatric-hand-transplant
#11
REVIEW
Arash Momeni, Benjamin Chang, L Scott Levin
The reconstructive principle of replacing "like with like" is best met with vascularized composite allotransplantation in which the components of an existing defect are "matched" to the greatest extent possible in a single stage restoration. Hand transplantation is a labor-intensive and time-intensive process and can be conceptualized into distinct phases that include (1) patient selection and preoperative preparation, (2) technical execution of the procedure, and (3) postoperative rehabilitation and follow-up...
November 2016: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/27556621/a-porcine-orthotopic-forelimb-vascularized-composite-allotransplantation-model-technical-considerations-and-translational-implications
#12
C Anton Fries, Carole Y Villamaria, Jerry R Spencer, Rory F Rickard, Vijay S Gorantla, Michael R Davis
BACKGROUND: The restoration of complex tissue deficits with vascularized composite allotransplantation is a paradigm shift in reconstructive surgery. Clinical adoption of vascularized composite allotransplantation is limited by the need for systemic immunosuppression, with associated morbidity and mortality. Small-animal models lack the biological fidelity and preclinical relevance to enable translation of immunologic insights to humans. Large-animal models have been described; however, limitations persist, including the inability of heterotopic models to evaluate functional nerve regeneration, and the sensitivity of primates to toxicity of immunosuppressive drugs...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27556604/effect-of-cold-preservation-on-chronic-rejection-in-a-rat-hindlimb-transplantation-model
#13
Jorge Bonastre, Luis Landín, Pedro Bolado, César Casado-Sánchez, Eduardo López-Collazo, Jesús Díez
BACKGROUND: Previous studies on solid organ transplantation have shown that cold ischemia contributes to the development of chronic allograft vasculopathy. The authors evaluated the effect of cold ischemia on the development of chronic rejection in vascularized composite allotransplantation. METHODS: Thirty rat hindlimbs were transplanted and divided into two experimental groups: immediate transplantation and transplantation after 7 hours of cold ischemia. The animals received daily low-dose immunosuppression with cyclosporine A for 2 months...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27517506/an-integrated-view-of-immune-monitoring-in-vascularized-composite-allotransplantation
#14
Antoine Sicard, Jean Kanitakis, Valérie Dubois, Palmina Petruzzo, Lionel Badet, Olivier Thaunat, Emmanuel Morelon
PURPOSE OF REVIEW: Vascularized composite allotransplantation (VCA) has several immunological peculiarities that imply a specific immune monitoring. Here, we provide an integrated view of current procedures of immune monitoring in VCA and potential complementary approaches learned from organ transplantation. RECENT FINDINGS: Because the skin is highly immunogenic and is the main target of the alloimmune response, immune monitoring in VCA essentially relies on visual inspection and pathological examination of for-causes and protocol skin biopsies...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27517505/donor-specific-antibodies-and-antibody-mediated-rejection-in-vascularized-composite-allotransplantation
#15
Annemarie Weissenbacher, Alexandre Loupy, Anil Chandraker, Stefan Schneeberger
PURPOSE OF REVIEW: The presence of donor-specific antibodies (DSA) increases the risk of graft failure. Although DSA characteristics, human leukocyte antigen class specificity, mean fluorescence intensity and immunoglobulin G subclasses, and their impact on the graft are quite well studied in solid organ transplants, very little information is known about their impact on vascularized composite allotransplantation (VCA). The aim of this review is to highlight recent publications regarding occurrence and effects of DSA, their follow-up and treatment in the field of VCA...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27517503/standardizing-psychosocial-assessment-for-vascularized-composite-allotransplantation
#16
Sheila Jowsey-Gregoire, Martin Kumnig
PURPOSE OF REVIEW: Vascularized composite allotransplantation (VCA) encompasses hand, face, uterus, penile and lower extremity transplantation. Psychosocial factors are recognized as important, but no standard approach to the evaluation, selection or posttransplant care has been described and thus, the development of a standardized approach is needed. RECENT FINDINGS: Various psychosocial assessment tools have been reported. Body image and the functional impact of hand versus face transplantation are notable issues...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27513765/clinical-considerations-for-vascularized-composite-allotransplantation-of-the-eye
#17
Edward H Davidson, Eric W Wang, Jenny Y Yu, Juan C Fernandez-Miranda, Dawn J Wang, Yang Li, Maxine Miller, Wesley N Sivak, Debra Bourne, Hongkun Wang, Mario G Solari, Joel S Schuman, Kia M Washington
Vascularized composite allotransplantation represents a potential shift in approaches to reconstruction of complex defects resulting from congenital differences as well as trauma and other acquired pathology. Given the highly specialized function of the eye and its unique anatomical components, vascularized composite allotransplantation of the eye is an appealing method for restoration, replacement, and reconstruction of the nonfunctioning eye. Herein, we describe conventional treatments for eye restoration and their shortcomings as well as recent research and events that have brought eye transplantation closer to a potential clinical reality...
October 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27500557/a-novel-rodent-orthotopic-forelimb-transplantation-model-that-allows-for-reliable-assessment-of-functional-recovery-resulting-from-nerve-regeneration
#18
B Kern, J D Budihardjo, S Mermulla, A Quan, C Cadmi, J Lopez, M Khusheim, S Xiang, J Park, G J Furtmüller, K A Sarhane, S Schneeberger, W P A Lee, A Hoke, S Tuffaha, G Brandacher
Improved nerve regeneration and functional outcomes would greatly enhance the utility of vascularized composite allotransplantation (VCA) such as hand and upper extremity transplantation. However, research aimed at achieving this goal has been limited by the lack of a functional VCA animal model. We have developed a novel rat mid-humeral forelimb transplant model that allows for the characterization of upper extremity functional recovery following transplantation. At the final end-point of 12 weeks, we found that animals with forelimb transplantation including median, ulnar, and radial nerve coaptation demonstrated significantly improved grip strength (1...
August 8, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27471833/recipient-derived-angiogenesis-with-short-term-immunosuppression-increases-bone-remodeling-in-bone-vascularized-composite-allotransplantation-a-pilot-study-in-a-swine-tibial-defect-model
#19
Dimitra Kotsougiani, Caroline A Hundepool, Liselotte F Bulstra, Patricia Friedrich, Alexander Y Shin, Allen T Bishop
Current vascularized composite allotransplantation (VCA) transplantation protocols rely upon life-long immune modulation to maintain tissue perfusion. Alternatively, bone-only VCA viability may be maintained in small animal models using surgical angiogenesis from implanted autogenous vessels to develop a neoangiogenic bone circulation that will not be rejected. This study tests the method's efficacy in a large animal model as a bridge to clinical practice, quantifying the remodeling and mechanical properties of porcine tibial VCAs...
July 29, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27391200/the-ethics-of-penile-transplantation-preliminary-recommendations
#20
Arthur L Caplan, Laura L Kimberly, Brendan Parent, Michael Sosin, Eduardo D Rodriguez
BACKGROUND: For men with significant genitourinary injury, penile transplantation is being considered as an option when reconstruction is not feasible or proves unacceptable to the injured patient. METHODS: A review of the literature was conducted to assess the current state of penile reconstruction and transplantation options, as well as to evaluate scholarly research addressing the ethical dimensions of penile transplantation. RESULTS: The state of penile transplantation is elementary...
July 7, 2016: Transplantation
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