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Vascularized composite allotransplantation

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205 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/29051396/facial-transplantation-an-update-of-results-and-perspectives-from-tissue-engineering
#1
Francesco Simonacci, Roberto Toni, Edoardo Raposio
BACKGROUND/AIM: Facial transplantation is a revolutionary procedure developed recently, which is indicated if autologous transfers fail to restore human appearance. More than 30 patients have undergone facial transplantation in different centers worldwide. Here, we provide an update on its main anatomical, surgical, immunological, ethical, and follow- up aspects. We also provide innovative perspectives of regenerative medicine and tissue engineering that could hold promise for this emerging surgical field...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28901186/recipient-adipose-derived-stem-cells-enhance-recipient-cell-engraftment-and-prolong-allotransplant-survival-in-a-miniature-swine-hind-limb-model
#2
Yur-Ren Kuo, Chien-Chang Chen, Yen-Chou Chen, Ching-Ming Chien
Donor mesenchymal stem cells (MSCs) could prolong vascularized composite allotransplantation (VCA) survival in our previous studies. However, recipient adipose tissue is easier to harvest than donor tissue for preconditioning modulation. Hence, this study investigated the efficacy of recipient autologous adipose-derived stem cells (rADSCs) for VCA survival. The heterotopic hind-limb transplantation from female donor to male recipient was performed in outbred miniature swine. Group I ( n = 6) was untreated controls...
August 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28873074/adipose-derived-cellular-therapies-in-solid-organ-and-vascularized-composite-allotransplantation
#3
Katlin B Stivers, Jason E Beare, Paula M Chilton, Stuart K Williams, Christina L Kaufman, James B Hoying
PURPOSE OF REVIEW: Controlling acute allograft rejection following vascularized composite allotransplantation requires strict adherence to courses of systemic immunosuppression. Discovering new methods to modulate the alloreactive immune response is essential for widespread application of vascularized composite allotransplantation. Here, we discuss how adipose-derived cellular therapies represent novel treatment options for immune modulation and tolerance induction in vascularized composite allotransplantation...
October 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28920719/-history-of-hand-transplantation-advancement-in-the-operative-technics-medications-and-the-survival-of-the-transplanted-hands-review-of-literature
#4
Vilmos Bíró
The author summarizes briefly the history of hand allograft transplantation, the basics of the operative technics, and the medicinal treatment of the immunosuppression. He establishes that this operation requires complicated team-work: many specialists must be united in the interest of the successful final outcome. The biggest problem is not the technical challenge of the complicated operation, but the ineffectiveness of immunosuppression, its complications; even though significant development has happened in this field and experimental results are also encouraging...
September 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28930103/seasonal-variability-precipitating-hand-transplant-rejection
#5
Rachel G Lopdrup, Marvee Turk, Thet Su Win, Francisco M Marty, David Molway, Stefan G Tullius, Bohdan Pomahac, Simon G Talbot
No abstract text is available yet for this article.
October 2017: Transplantation
https://www.readbyqxmd.com/read/28949391/handtransplantation-snart-verklighet-i-sverige
#6
Lars Dahlin, Marianne Arner, Per Fredrikson, Tobias Laurell, Sassu Paolo, Jonas Wadström, Mikael Wiberg
English summary: Hand transplantation in Sweden - preparations under way Some patients with a uni- or bilateral hand- or forearm amputation cannot use a hand prosthesis, although high-tech prostheses have been developed. A hand transplantation, particularly for those with bilateral amputations, may be an alternative solution. In a hand-transplanted patient, grip function, strength, sensibility and subsequent improved quality of life can be restored. Risks related to immunosuppression must be balanced by expected benefits, and thorough selection of patients has to be performed from both medical and psychological point of view...
September 25, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28964930/grasping-with-a-new-hand-improved-performance-and-normalized-grasp-selective-brain-responses-despite-persistent-functional-changes-in-primary-motor-cortex-and-low-level-sensory-and-motor-impairments
#7
Kenneth F Valyear, Daniela Mattos, Benjamin A Philip, Christina Kaufman, Scott H Frey
Hand loss can now be reversed through surgical transplantation years or decades after amputation. Remarkably, these patients come to use their new hand to skilfully grasp and manipulate objects. The brain mechanisms that make this possible are unknown. Here we test the hypothesis that the anterior intraparietal cortex (aIPC) - a multimodal region implicated in hand preshaping and error correction during grasping - plays a key role in this compensatory grasp control. Motion capture and fMRI are used to characterize hand kinematics and brain responses during visually guided grasping with a transplanted hand at 26 and 41 months post-transplant in patient DR, a former hand amputee of 13 years...
September 28, 2017: NeuroImage
https://www.readbyqxmd.com/read/28985978/the-ethics-of-hand-transplantation-a%C3%A2-systematic%C3%A2-review
#8
Carisa M Cooney, Charalampos Siotos, Jeffrey W Aston, Ricardo J Bello, Stella M Seal, Damon S Cooney, Jaimie T Shores, Gerald Brandacher, W P Andrew Lee
PURPOSE: We conducted a systematic review to document ethical concerns regarding human upper extremity (UE) allotransplantation and how these concerns have changed over time. METHODS: We performed a systematic review of 5 databases to find manuscripts addressing ethical concerns related to UE allotransplantation. Inclusion criteria were papers that were on the topic of UE allotransplantation, and related ethical concerns, written in English. We extracted and categorized ethical themes under the 4 principles of bioethics: Autonomy, Beneficence, Nonmaleficence, and Justice...
October 4, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28888310/role-of-facial-vascularized-composite-allotransplantation-in-burn-patients
#9
REVIEW
Deepak Bharadia, Indranil Sinha, Bohdan Pomahac
Face transplantation can provide improved quality of life to patients with extensive burn injuries. Facial vascularized composite allotransplantation (VCA) offers a new paradigm of treatment options, serving as a powerful reconstructive tool to restore facial form and function. Although currently facial VCA patients must follow a lifelong regimen of immunosuppression medications and suffer a risk of rejection, in properly selected patients, facial VCA can be a transformative operation and can improve quality of life...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28953521/lymphatic-reconstitution-and-regeneration-after-face-transplantation
#10
Michael Sosin, Gerhard S Mundinger, Cinthia B Drachenberg, Eduardo D Rodriguez
BACKGROUND: The purpose of this study was to investigate whether lymphatic reconstitution and regeneration occurs after clinical facial transplantation using indocyanine green lymphography and immunohistochemical markers. METHODS: Allograft skin biopsies at multiple posttransplant time points were stained with Lyve1 lymphatic antibody and other endothelial antibodies. Staining intensity was interpreted on a scale of none, mild, moderate, and strong by 2 investigators and consolidated by a third party for final interpretation...
November 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28985877/intra-graft-injection-of-tacrolimus-promotes-survival-of-vascularized-composite-allotransplantation
#11
Radu Olariu, Julie Denoyelle, Franck M Leclère, Dzhuliya V Dzhonova, Thusitha Gajanayake, Yara Banz, Michael Hayoz, Mihai Constantinescu, Robert Rieben, Esther Vögelin, Adriano Taddeo
BACKGROUND: Immunosuppressive therapies derived from solid organ transplantation are effective in promoting survival of vascularized composite allotransplantation (VCA), but they cause serious side effects that are difficult to justify for this non-life-saving procedure. Unlike solid organ transplantation, hand and face transplants offer the possibility of site-specific immunosuppression for reducing systemic exposure while increasing intra-graft concentrations of the drug. Therefore, in this study, we tested whether a single intra-graft injection tacrolimus could promote VCA survival...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/21554424/achievements-and-challenges-in-composite-tissue-allotransplantation
#12
REVIEW
Stefan Schneeberger, Luis Landin, Jerzy Jableki, Peter Butler, Christoph Hoehnke, Gerald Brandacher, Emmanuel Morelon
Overall, more than 60 hand/forearm/arm transplantations and 16 face transplantations have been performed in the past 12 years. In the European experience summarized here, three grafts have been lost in response to a vascular thrombosis (n = 1), rejection and incompliance with immunosuppression (n = 1) and death (n = 1). The overall functional and esthetic outcome is very satisfactory, but serious side effects and complications related to immunosuppression are challenges hindering progress in this field. The high levels of immunosuppression, skin rejection, nerve regeneration, donor legislation and the acceptance level need to be addressed to promote growth of this promising new field in transplantation and reconstructive surgery...
August 2011: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/23001085/upper-extremity-transplantation-using-a-cell-based-protocol-to-minimize-immunosuppression
#13
Stefan Schneeberger, Vijay S Gorantla, Gerald Brandacher, Adriana Zeevi, Anthony J Demetris, John G Lunz, Diana M Metes, Albert D Donnenberg, Jaimie T Shores, Andrea F Dimartini, Joseph E Kiss, Joseph E Imbriglia, Kodi Azari, Robert J Goitz, Ernest K Manders, Vu T Nguyen, Damon S Cooney, Galen S Wachtman, Jonathan D Keith, Derek R Fletcher, Camila Macedo, Raymond Planinsic, Joseph E Losee, Ron Shapiro, Thomas E Starzl, W P Andrew Lee
OBJECTIVE: To minimize maintenance immunosuppression in upper-extremity transplantation to favor the risk-benefit balance of this procedure. BACKGROUND: Despite favorable outcomes, broad clinical application of reconstructive transplantation is limited by the risks and side effects of multidrug immunosuppression. We present our experience with upper-extremity transplantation under a novel, donor bone marrow (BM) cell-based treatment protocol ("Pittsburgh protocol")...
February 2013: Annals of Surgery
https://www.readbyqxmd.com/read/28658200/critical-ischemia-times-and-the-effect-of-novel-preservation-solutions-htk-n-and-tiprotec-on-tissues-of-a-vascularized-tissue-isograft
#14
COMPARATIVE STUDY
Franka Messner, Theresa Hautz, Michael J F Blumer, Mario Bitsche, Elisabeth J Pechriggl, Martin Hermann, Bettina Zelger, Bernhard Zelger, Dietmar Öfner, Stefan Schneeberger
BACKGROUND: We herein investigate critical ischemia times and the effect of novel preservation solutions such as new histidine-tryptophan-ketoglutarate (HTK-N) and TiProtec on the individual tissues of a rat limb isograft. METHODS: Orthotopic hind-limb transplantations were performed in male Lewis rats after 2 hours, 6 hours, or 10 hours of cold ischemia (CI). Limbs were flushed and stored in HTK-N, TiProtec, HTK, or saline solution. Muscle, nerve, vessel, skin, and bone samples were procured on day 10 for histology, immunohistochemistry, confocal and electron microscopy, and quantitative real-time polymerase chain reaction analysis...
September 2017: Transplantation
https://www.readbyqxmd.com/read/28845920/ethical-issues-in-pediatric-face-transplantation
#15
Ana-Gabriela Benghiac, Jeremy R Garrett, Brian S Carter
Facial transplantation has become a reality in adult medicine. Children are subject to congenital craniofacial differences, disease-related, traumatic, or thermochemical craniofacial changes and might be suitable for face transplantation. This manuscript addresses unique ethical issues in considering potential pediatric face transplant. These challenges are operant at the individual, technologic, and psychosocial level for clinicians, investigators, and society.
November 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28829409/surgical-angiogenesis-in-porcine-tibial-allotransplantation-a-new-large-animal-bone-vascularized-composite-allotransplantation-model
#16
Dimitra Kotsougiani, Caroline A Hundepool, Joost I Willems, Patricia Friedrich, Alexander Y Shin, Allen T Bishop
Segmental bone loss resulting from trauma, infection malignancy and congenital anomaly remains a major reconstructive challenge. Current therapeutic options have significant risk of failure and substantial morbidity. Use of bone vascularized composite allotransplantation (VCA) would offer both a close match of resected bone size and shape and the healing and remodeling potential of living bone. At present, life-long drug immunosuppression (IS) is required. Organ toxicity, opportunistic infection and neoplasm risks are of concern to treat such non-lethal indications...
August 13, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28823033/the-combination-of-mitomycin-induced-blood-cells-with-a-temporary-treatment-of-ciclosporin-a-prolongs-allograft-survival-in-vascularized-composite-allotransplantation
#17
Christian Andreas Radu, Sebastian Fischer, Yannick Diehm, Otto Hetzel, Florian Neubrech, Laura Dittmar, Christian Kleist, Martha Maria Gebhard, Peter Terness, Ulrich Kneser, Jurij Kiefer
BACKGROUND: Vascularized composite allotransplantation (VCA) is a rapidly expanding field of transplantation and provides a potential treatment for complex tissue defects. Peripheral blood mononuclear cells (PBMCs) shortly incubated with the antibiotic and chemotherapeutic agent mitomycin C (MMC) can suppress allogeneic T cell response and control allograft rejection in various organ transplantation models. MMC-incubated PBMCs (MICs) are currently being tested in a phase I clinical trial in kidney transplant patients...
August 19, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28742686/bioengineering-a-human-face-graft-the-matrix-of-identity
#18
Jérôme Duisit, Louis Maistriaux, Adriano Taddeo, Giuseppe Orlando, Virginie Joris, Emmanuel Coche, Catherine Behets, Jan Lerut, Chantal Dessy, Giulio Cossu, Esther Vögelin, Robert Rieben, Pierre Gianello, Benoît Lengelé
OBJECTIVE: During the last decade, face allotransplantation has been shown to be a revolutionary reconstructive procedure for severe disfigurements. However, offer to patients remains limited due to lifelong immunosuppression. To move forward in the field, a new pathway in tissue engineering is proposed. BACKGROUND: Our previously reported technique of matrix production of a porcine auricular subunit graft has been translated to a human face model. METHODS: 5 partial and 1 total face grafts were procured from human fresh cadavers...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28737527/genitourinary-vascularized-composite-allotransplantation
#19
Ilse M Schol, Dicken S C Ko, Curtis L Cetrulo
PURPOSE OF REVIEW: Genitourinary vascularized allotransplantation (GUVCA) is gaining interest as a treatment option for patients with functional and aesthetic urogenital tissue loss. Only three cases have been done worldwide and research on the implementation and feasibility of this procedure is in an elementary state. RECENT FINDINGS: The psychosocial impact and ethical considerations with GUVCA are remote, particularly because of the intimate and personal nature of genital tissue...
July 22, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28734534/elbow-vascularized-composite-allotransplantation-surgical-anatomy-and-technique
#20
Zvi Steinberger, Heng Xu, Nikolas H Kazmers, Stephanie Thibaudeau, Russel G Huffman, L Scott Levin
BACKGROUND: Elbow reconstruction with vascularized composite allotransplantation (VCA) may hold promise in treating end-stage arthritis as no current treatment is both functional and durable. We describe the vascular and gross anatomy of the elbow in the context of VCA procurement and propose a step-by-step surgical technique for human elbow VCA. METHODS: We injected latex in the arterial tree of 16 fresh adult cadaveric upper extremities. We identified and measured arteries and nerves and their branch points relative to the medial epicondyle...
August 2017: Journal of Shoulder and Elbow Surgery
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