MHC Class I Matching Between Donors and Recipients Influences the Skin Tolerance of Vascularized Composite Allografts

The development of VCA tolerance protocols would obviate the need for chronic immunosuppression and allow widespread use of this highly promising reconstructive modality. However, achieving robust tolerance of the skin component of VCAs has proven particularly challenging in pre-clinical large animal models. Our laboratory has recently reported acceptance of VCAs (>600 d), including the skin component, across a haploidentical MHC barrier in a miniature swine model using a mixed chimerism approach. In this study, we investigated whether sharing of MHC class I and/ or class II between donor and recipient influences skin tolerance.