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The Specificity and Management of Vascularized Composite Tissue Allotransplant in Sensitized Recipients 血管化复合组织同种异体移植致敏受体的特异性及处理
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970034
Hong-lin Xu, Bo Chen, Deborah R. Corbin, S. Ildstad
{"title":"The Specificity and Management of Vascularized Composite Tissue Allotransplant in Sensitized Recipients","authors":"Hong-lin Xu, Bo Chen, Deborah R. Corbin, S. Ildstad","doi":"10.4161/23723505.2014.970034","DOIUrl":"https://doi.org/10.4161/23723505.2014.970034","url":null,"abstract":"Sensitization, a state of the presence of donor-specific antibody (DSA) in recipient, has usually been considered an absolute contraindication to solid organ transplantation including vascularized composite tissue allotransplantation (VCA), due to the antibody-mediated rejection (AMR). However, the role of sensitization in VCA rejection is largely unstudied. We recently reported in a rat model that rejection of VCA was accelerated but not hyperacutely in the presence of allosensitization. The rejection of VCA in sensitized recipients is mainly cellular-mediated as evidenced by dense lymphocytic infiltrates and no antibody deposition in biopsies.","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121352286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Achieving Tolerance in a Mismatched VCA Transplant While Reducing the Risk of GVHD: The Goal of Transient Chimerism 在降低GVHD风险的同时实现错配VCA移植的耐受性:短暂嵌合的目标
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970037
Bruce J. Swearingen, Jeff Chang, Tiffany Butts, S. Graves, R. Storb, D. Mathes
{"title":"Achieving Tolerance in a Mismatched VCA Transplant While Reducing the Risk of GVHD: The Goal of Transient Chimerism","authors":"Bruce J. Swearingen, Jeff Chang, Tiffany Butts, S. Graves, R. Storb, D. Mathes","doi":"10.4161/23723505.2014.970037","DOIUrl":"https://doi.org/10.4161/23723505.2014.970037","url":null,"abstract":"BACKGROUND: Transplantation of vascularized composite allografts (VCA) offers the opportunity to restore form and function. Clinical application is limited due to the necessity of life-long immunosuppression. One promising method of inducing tolerance to an organ allograft is the development of mixed chimerism. We have demonstrated that a nonmyeloablative stem cell transplant can lead to tolerance in a mismatched dog model. However, the application of this protocol has been limited by graft-versus-host disease (GVHD). We have observed several animals that, after an initial period of donor cell engraftment, lost their stem cell allograft but remained tolerant to the VCA. Conversely, animals that retained persistent donor cell chimerism inevitably developed GVHD. The hypothesis for this study was that our non-myeloablative hematopoietic stem cell transplant protocol could be used to induce tolerance to a recipient VCA without the need for persistent donor cell chimerism.","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128370322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Costimulatory Blockade in Combination with Donor Bone Marrow Infusion Induces Immune Tolerance Across A Full MHC Barrier In A Translational Large Animal Vascularized Composite Allotransplantation Model 在翻译的大型动物血管化复合同种异体移植模型中，共刺激阻断联合供体骨髓输注诱导免疫耐受跨越全MHC屏障
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970056
Angelo A Leto Barone, Z. Ibrahim, G. Furtmüller, K. Sarhane, Yongchun Wang, Devin Miller, Madeline L. Fryer, Mohammed Alrakan, K. Sarkar, J. Shores, S. Bonawitz, C. Gordon, J. Sacks, G. Raimondi, D. Cooney, Zhaoli Sun, W. Lee, G. Brandacher
{"title":"Costimulatory Blockade in Combination with Donor Bone Marrow Infusion Induces Immune Tolerance Across A Full MHC Barrier In A Translational Large Animal Vascularized Composite Allotransplantation Model","authors":"Angelo A Leto Barone, Z. Ibrahim, G. Furtmüller, K. Sarhane, Yongchun Wang, Devin Miller, Madeline L. Fryer, Mohammed Alrakan, K. Sarkar, J. Shores, S. Bonawitz, C. Gordon, J. Sacks, G. Raimondi, D. Cooney, Zhaoli Sun, W. Lee, G. Brandacher","doi":"10.4161/23723505.2014.970056","DOIUrl":"https://doi.org/10.4161/23723505.2014.970056","url":null,"abstract":"Fully MHCand gender mismatched MGH miniature swine underwent heterotopic hind-limb transplantation. Recipient animals received a short course of tacrolimus monotherapy, C/¡ donor BM infusion (60x10cells/kg), and CTLA4Ig (abatacept). Short course tacrolimus only and untreated animals served as controls. Chimerism was assessed by SRY-gene PCR analysis. Alloreactivity against donor antigens was assessed in vitro using CFSE-based Mixed Lymphocyte Reaction (CFSE-MLR) assays. Robust immune tolerance in vivo was assessed by secondary skin grafting. Tolerance maintenance upon allograft removal was tested in vitro by CFSE-MLR. Donor-specific antibodies (DSA) production was assessed using flow cytometry. Results","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125478217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Incidence of Successful Steroid Weaning in a Series of 8 Hand Transplant Recipients 8例手部移植受者成功脱机类固醇的发生率
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970054
C. Kaufman, R. Ouseph, J. Kutz, Yorell Manon-Matos, B. Blair, M. Marvin
{"title":"Incidence of Successful Steroid Weaning in a Series of 8 Hand Transplant Recipients","authors":"C. Kaufman, R. Ouseph, J. Kutz, Yorell Manon-Matos, B. Blair, M. Marvin","doi":"10.4161/23723505.2014.970054","DOIUrl":"https://doi.org/10.4161/23723505.2014.970054","url":null,"abstract":"","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122561791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Inaugural Issue of VCA-Vascularized Composite Allotransplantation 血管化vca复合异体移植创刊号
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.973775
G. Brandacher, D. Sachs, W. Lee
{"title":"Inaugural Issue of VCA-Vascularized Composite Allotransplantation","authors":"G. Brandacher, D. Sachs, W. Lee","doi":"10.4161/23723505.2014.973775","DOIUrl":"https://doi.org/10.4161/23723505.2014.973775","url":null,"abstract":"","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124532829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Technical Approach to Penile Transplantation 阴茎移植的技术方法
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970913
S. Tuffaha, J. Sacks, J. Shores, G. Brandacher, W. Lee, D. Cooney, R. Redett
{"title":"Technical Approach to Penile Transplantation","authors":"S. Tuffaha, J. Sacks, J. Shores, G. Brandacher, W. Lee, D. Cooney, R. Redett","doi":"10.4161/23723505.2014.970913","DOIUrl":"https://doi.org/10.4161/23723505.2014.970913","url":null,"abstract":"Penile transplantation may provide improved outcomes as compared to autogenous phalloplastic reconstruction. The optimal approach to vascularizing penile allografts is unknown. In penile replantation typically only the dorsal arteries are repaired, but utilizing the cavernosal and external pudendal arteries may improve erectile function and shaft skin perfusion, respectively. The authors sought to demonstrate the technical feasibility of utilizing the dorsal, cavernosal, and external pudendal vessels for penile transplantation and to assess differences in their perfusion territories.","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132178402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Immunomodulation with Adipose and Bone Marrow-derived Mesenchymal Stem Cells in Vascularized Composite Allotransplantation 脂肪和骨髓间充质干细胞在血管化复合异体移植中的免疫调节作用
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970899
J. Plock, Jonas T. Schnider, Wensheng Zhang, W. Tsuji, R. Schweizer, Nataliya Kostereva, P. Fanzio, S. Ravuri, M. Solari, K. Marra, V. Gorantla
{"title":"Immunomodulation with Adipose and Bone Marrow-derived Mesenchymal Stem Cells in Vascularized Composite Allotransplantation","authors":"J. Plock, Jonas T. Schnider, Wensheng Zhang, W. Tsuji, R. Schweizer, Nataliya Kostereva, P. Fanzio, S. Ravuri, M. Solari, K. Marra, V. Gorantla","doi":"10.4161/23723505.2014.970899","DOIUrl":"https://doi.org/10.4161/23723505.2014.970899","url":null,"abstract":"Reconstructive transplantation is a clinical reality. Graft sustenance requires life-long immunosuppression with coincident adverse effects. Therapies incorporating adipose tissueand bone marrow-derived mesenchymal stem cells (AD-MSC/BM-MSCs) have shown promising effects in experimental autoimmune diseases, solid organ transplantation and vascularized composite allotransplantation (VCA). Clinical translation of these therapies must consider collateral effects of depletional conditioning protocols. For the first time, we compare AD-MSCs versus BM-MSCs in VCA.","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124230624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corticosteroid Withdrawal in Vascularized Composite Allotransplantation 血管化复合异体移植中皮质类固醇的停用
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970051
J. Diaz-Siso, S. Fischer, Geoffroy C. Sisk, E. Bueno, S. Talbot, M. Carty, F. Marty, B. Pomahac, S. Tullius
{"title":"Corticosteroid Withdrawal in Vascularized Composite Allotransplantation","authors":"J. Diaz-Siso, S. Fischer, Geoffroy C. Sisk, E. Bueno, S. Talbot, M. Carty, F. Marty, B. Pomahac, S. Tullius","doi":"10.4161/23723505.2014.970051","DOIUrl":"https://doi.org/10.4161/23723505.2014.970051","url":null,"abstract":"Steroid avoidance in immunosuppression regimes after solid organ transplantations is feasible without hindering graft outcome or introducing complications. In vascular composite tissue allotransplantations (VCA), however, discharge of steroids is treated with caution, due to the various types of tissues involved and the associated belief of high immunogenicity of skin. In this study we present our experience with steroid withdrawal in 5 VCA recipients.","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127821659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Significance and Management of Low Grade Rejection in Hand Transplantation 手部移植低级别排斥反应的意义及处理
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.970869
Bahar Bassiri Gharb, A. Rampazzo, J. Kutz, B. Blair, R. Ouseph, M. Marvin, C. Kaufman
{"title":"Significance and Management of Low Grade Rejection in Hand Transplantation","authors":"Bahar Bassiri Gharb, A. Rampazzo, J. Kutz, B. Blair, R. Ouseph, M. Marvin, C. Kaufman","doi":"10.4161/23723505.2014.970869","DOIUrl":"https://doi.org/10.4161/23723505.2014.970869","url":null,"abstract":"Episodes of mild cellular rejection represent the majority of the acute rejection events in vascularized composite allotransplantation. Management of low grade rejection still represents a therapeutic challenge as an aggressive treatment can accelerate the occurrence of side effects of the systemic immunosuppressive therapy. In absence of clinical signs, the natural evolution of histologically diagnosed grade I rejection is not well understood.","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"22 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133170209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Attitudes Toward Vascularized Composite Allotransplantation of the Hands and Face in an Urban Population 城市人群对带血管的复合异体手脸移植的态度
Vascularized Composite Allotransplantation Pub Date : 2014-01-02 DOI: 10.4161/23723505.2014.975021
D. Sarwer, S. Ritter, K. Reiser, J. Spitzer, B. Baumann, Sundip N. Patel, A. Mazzarelli, S. Levin, Stacey L. Doll, A. Caplan
{"title":"Attitudes Toward Vascularized Composite Allotransplantation of the Hands and Face in an Urban Population","authors":"D. Sarwer, S. Ritter, K. Reiser, J. Spitzer, B. Baumann, Sundip N. Patel, A. Mazzarelli, S. Levin, Stacey L. Doll, A. Caplan","doi":"10.4161/23723505.2014.975021","DOIUrl":"https://doi.org/10.4161/23723505.2014.975021","url":null,"abstract":"Background: Almost 100 hand and face transplants have been performed worldwide. Their success has generated enthusiasm within the medical community, however, little is known about public attitudes toward vascularized composite allotransplantation (VCA) of the hands and face as compared to solid organ transplantation. The objective of this survey study was to assess these attitudes and the acceptability and potential barriers to the further growth of these procedures. Methods: Cooper University Hospital Emergency Department (Camden, New Jersey) patients, accompanying family members and friends ≥18 years of age were surveyed about knowledge of and attitudes toward organ, hand, and face transplants as well as preferences as a potential VCA donor or recipient. The socioeconomic aspects of VCA also were assessed. Results: A total of 1,027 individuals participated. Approximately 70% (69.7%) of respondents indicated that they would want to be organ donors, although only 37.1% reported donor registrations on their driver's license. Respondents demonstrated greatest willingness to donate solid organs upon death: kidneys (77.5%), liver (77.1%), and heart (76.4%). Willingness to donate was less for hands (54.6%) and face (44.0%). Similarly, respondents were more willing to receive a kidney (85.2%) than a hand (60.0%) or face (49.4%). Conclusions: Respondents were more willing to be donors or recipients of solid organs than of hands or face. However, substantial percentages of individuals indicated a willingness to donate or receive hands or a face. As VCA continues to evolve, knowledge of public attitudes toward VCA will be critical for organ procurement organizations, health system engagement, and funding for relevant research.","PeriodicalId":372758,"journal":{"name":"Vascularized Composite Allotransplantation","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127849600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 29
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