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Vascularized composite allotransplantation

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153 papers 25 to 100 followers Includes face, upper limb and hand, uterine and penile transplantation
By Mafer Amber QxMD ambassador, Mexican med student currently in 4° year, doing clinical research in vascularized composite allotransplantation
https://www.readbyqxmd.com/read/28058213/face-transplantation-anesthetic-challenges
#1
REVIEW
Aparna Dalal
Face transplantation is a complex vascular composite allotransplantation (VCA) surgery. It involves multiple types of tissue, such as bone, muscles, blood vessels, nerves to be transferred from the donor to the recipient as one unit. VCAs were added to the definition of organs covered by the Organ Procurement and Transplantation Network Final Rule and National Organ Transplant Act. Prior to harvest of the face from the donor, a tracheostomy is usually performed. The osteotomies and dissection of the midface bony skeleton may involve severe hemorrhagic blood loss often requiring transfusion of blood products...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28029476/a-murine-model-of-orthotopic-periorbital-subunit-transplantation
#2
Bowen Gao, Bin Li, Xinxin Li, Jinhong Bae, Kaiyan Xiao, 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. We developed an orthotopic periorbital transplantation model in rats to facilitate further experimentation in this field. METHODS: In anatomical studies, the vascular distribution to and innervation of the periorbital unit were identified and recorded...
October 28, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28003109/bilateral-hand-transplantation-supporting-the-patient-s-choice
#3
M Dumont, L Sann, A Gazarian
Bilateral hand transplantation, as a fairly new reconstructive option for amputees, raises major ethical questions. This article, which is based on the reflections arising from the rich experience of Lyon's team in this field, addresses the topic of supporting the patient in his choice for or against this procedure. How should autonomy be understood in this particular setting? The developing field of composite tissue allotransplantation needs to establish a common thinking on this subject. The article emphasises that, even if it is their right to decide, patients have to be carefully supported to help them make the most consolidated choice possible in this challenging procedure...
November 24, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27984215/psychosocial-evaluation-for-first-hand-allotransplantation-in-taiwan
#4
Nien-Mu Chiu, Yur-Ren Kuo, Yu Lee, Chien-Chang Chen
Hand transplantation has raised ethical and psychological concerns. Few studies have focused on reasons for not selecting candidates on waiting lists. To describe the psychosocial evaluation of referred prospective hand transplant candidates, we investigated candidate suitability by using 22-month follow-up data regarding the first hand transplant recipient in Taiwan. Pretransplant psychosocial assessments comprised an interview with 2 psychiatrists, a social worker, and a psychologist, followed by intelligence quotient scoring with the Wechsler Adult Intelligence Scale and Taiwanese Depression Questionnaire...
December 14, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28032849/reflections-on-a-decade-of-face-transplantation
#5
Giorgio Giatsidis, Indranil Sinha, Bohdan Pomahac
On November 27, 2005, Isabelle Dinoire underwent the world's first partial face transplant in Amiens (France) after a dog attack had left her face severely disfigured. The abrupt surgical leap found the medical community and society unprepared to deal with the scientific, ethical, and societal implications of a surgical procedure that was striving to transition from sci-fi novels to science. Today, 10 years and over 35 transplants later, public opinion has become accustomed to the concept of "face restoration" through transplantation...
April 26, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28027248/quality-of-life-after-face-transplantation-outcomes-assessment-tools-and-future-directions
#6
Mario A Aycart, Harriet Kiwanuka, Nicco Krezdorn, Muayyad Alhefzi, Ericka M Bueno, Bohdan Pomahac, Megan L Oser
BACKGROUND: Face transplantation has emerged as a clinical reality for the restoration of complex facial defects. Critical to the advancement of the burgeoning field of reconstructive transplantation is the quality of the methods used to measure and report the impact of face transplantation on quality of life. METHODS: A systematic search using PubMed and EMBASE was conducted for all studies matching the a priori inclusion criteria from 2005 through 2015. Bibliographies of included studies were also reviewed...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28024304/nasal-unit-transplantation-a-cadaveric-anatomical-feasibility-study
#7
Amir H Dorafshar, Gerhard S Mundinger, Brent Robinson, Sami Tuffaha, Gerald Brandacher, Patrick Byrne, Robert L Walton
Background The science and technical acumen in the field of vascularized composite allotransplantation has progressed rapidly over the past 15 years, and transplantation of specialized units of the face, such as the nose, appears possible. No study to date has evaluated the technical feasibility of isolated nasal unit transplantation (NUT). In this study, we explore the anatomy and technical specifics of NUT. Methods In this study, four fresh cadaver heads were studied. Bilateral vascular pedicle dissections were performed in each cadaver...
December 26, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28005656/skeletal-changes-of-an-osteomyocutaneous-facial-allograft-five-years-following-transplantation
#8
Bahar Bassiri Gharb, Antonio Rampazzo, Gaby Doumit, Steven Bernard, Maria Siemionow, Francis Papay, Risal Djohan
BACKGROUND: More than 30 face transplantations have been performed worldwide, most including part of the facial skeletal framework. In this study, the modifications of the skeletal component of a facial allograft were evaluated. METHODS: Standard head computed tomography (CT) scans, CT angiogram, and bone mineral densitometry were evaluated. Cephalometric analysis was performed. The pre and postoperative CT images were overlapped and the skeletal changes were expressed in a numeric and color-coded scale...
December 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27941036/the-miracle-of-face-transplantation-after-10-years
#9
REVIEW
Maria Siemionow
INTRODUCTION: At the 10th year anniversary of the first face transplantation, there are currently 36 patients worldwide, who are the recipients of faces coming from human donors. AREAS OF AGREEMENT: Despite the initial debates and ethical concerns, face transplantation became a clinical reality with satisfactory functional outcomes. AREAS OF CONTROVERSY: The areas of controversy still include the impact of lifelong immunosuppression on otherwise healthy patients as well as the selection process of face transplant candidates...
December 2016: British Medical Bulletin
https://www.readbyqxmd.com/read/27941098/from-face-off-to-the-face-race-the-case-of-isabelle-dinoire-and-the-future-of-the-face-transplant
#10
Fay Bound Alberti
Isabelle Dinoire, the world's first face transplant recipient has died, 11 years after the procedure that brought her unwanted fame and media attention. While medical debates centre mainly on ethical and medical concerns like immunosuppressant use, the psychological hazards of face transplants are still being overlooked. Using medical and media reports and examining the gendering of clinical and patient narratives, this article argues we need to look again at face transplants and their motivation for individuals as well as society...
December 9, 2016: Medical Humanities
https://www.readbyqxmd.com/read/27859595/recipient-bone-marrow-derived-stromal-cells-prolong-graft-survival-in-a-rat-hind-limb-allotransplantation-model
#11
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/27879593/triptolide-reduces-the-required-dose-of-tacrolimus-by-attenuating-inflammation-enhancing-immunosuppression-and-increasing-donor-chimerism-in-a-heterotopic-hindlimb-transplantation-model
#12
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/27893612/the-influence-of-timing-and-frequency-of-adipose-derived-mesenchymal-stem-cell-therapy-on-immunomodulation-outcomes-after-vascularized-composite-allotransplantation
#13
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 for minimization of immunosuppression. Adipose-derived (AD) mesenchymal stem cells (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 outcomes after VCA. METHODS: Lewis rats received full-mismatched Brown Norway rat hindlimb transplants...
January 2017: Transplantation
https://www.readbyqxmd.com/read/27879599/total-human-eye-allotransplantation-developing-surgical-protocols-for-donor-and-recipient-procedures
#14
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/27859672/immune-activation-and-regulation-related-patterns-in-stable-hand-transplant-recipients
#15
Dorota Kamińska, Katarzyna Kościelska-Kasprzak, Magdalena Krajewska, Adam Chełmoński, Jerzy Jabłecki, Marcelina Żabińska, Marta Myszka, Mirosław Banasik, Maria Boratyńska, Agnieszka Gomółkiewicz, Piotr Dzięgiel, Marian Klinger
We assessed cell subsets and expression of a set of genes related to the T-cell populations in peripheral blood mononuclear cells to elucidate whether immune status of stable hand transplant recipients (HTx) differs from stable kidney transplant recipients (KTx). The study was conducted on five HTx 4.8 ± 1.7 years after transplantation and 30 stable KTx 7.9 ± 2.4 years after transplantation as well as 18 healthy volunteers. The research involved PBMC gene expression analysis of CD4, CD8, CTLA4, GZMB, FOXP3, IL10, IL4, ILR2A, NOTCH, PDCD1, PRF1, TGF-B, and TNF-A genes on a custom-designed low-density array (TaqMan) as well as flow cytometry assessment of lymphocyte subpopulations...
November 9, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27861292/long-term-tolerance-toward-haploidentical-vascularized-composite-allograft-transplantation-in-a-canine-model-using-bone-marrow-or-mobilized-stem-cells
#16
Jeff Chang, Scott S Graves, Tiffany Butts-Miwongtum, George E Sale, Rainer Storb, David Woodbridge Mathes
BACKGROUND: The development of safe and reliable protocols for the transplantation of the face and hands may be accomplished with animal modeling of transplantation of vascularized composite allografts (VCA). Previously, we demonstrated that tolerance to a VCA could be achieved after canine recipients were simultaneously given marrow from a dog leukocyte antigen-identical donor. In the present study, we extend those findings across a dog leukocyte antigen mismatched barrier. METHODS: Eight recipient dogs received total body irradiation (4...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27873528/transplantation-of-vascularized-composite-allografts-review-of-current-knowledge
#17
M Molitor
Transplantation in reconstructive surgery has been performed for more than 20 years, although the official beginning of these procedures is considered the first successful transplantation of the hand in 1998. The original name "Composite Tissue Transplantation" has been used less frequently; more common is the term "Vascularized Composite Allotransplant", which better describes the basis of the procedure. There have been so far approximately 180 transplantations performed, the exact number is difficult to find...
2016: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/27888277/looking-the-world-in-the-face-the-benefits-and-challenges-of-facial-transplantation-for-blind-patients
#18
Katrina A Bramstedt, Jan A Plock
Total bilateral blindness in the setting of facial transplantation is a controversial matter. Some transplant teams exclude these candidates, while others accept them onto their facial transplant waiting list. Using 3 cases, the clinical and ethical complexity of total bilateral blindness is explored. Guidance (medical, psychological, and social) for total bilateral blindness as both an inclusion and exclusion criterion is provided, with the stipulation that total bilateral blindness should not be an automatic exclusion criterion for facial transplantation...
November 25, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27893628/watershed-areas-in-face-transplantation
#19
Bahar Bassiri Gharb, Russell S Frautschi, Brianna C Halasa, Gaby D Doumit, Risal S Djohan, Steven L Bernard, Brian R Gastman, Maria Z Siemionow, Francis A Papay, Antonio Rampazzo
BACKGROUND: Maxillary artery has traditionally been considered the main blood supply of the facial skeleton. However, the deep and concealed location makes the harvest of facial allografts based on this artery challenging, giving preference to the facial artery. There is growing evidence that the junction between the hard and soft palate may represent a watershed area in facial artery based allografts. The aim of this study was to review the occurrence of partial allograft necrosis and modify the available craniofacial techniques allowing for a reliable harvest of maxillary artery based facial allografts...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27826601/plasma-micrornas-are-potential-biomarkers-of-acute-rejection-after-hindlimb-transplantation-in-rats
#20
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
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