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Long-Term Prevention of Rejection and Combination Drug Therapy

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Transplantation of Composite Tissue Allografts

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This chapter provides an overview of the use of the most current immunosuppressive medications in composite tissue transplantation, and the immunological issues regarding the long-term survival of tissue allografts. Because the clinical application of composite tissue transplantation has been either anecdotal (laryngeal, bone, tendon) or recent (hand transplantation), the risk of late allograft loss is for the most part extrapolated from the organ transplantation literature. Peripheral nerve transplantation is unique because the nerve allograft provides only a temporary scaffold to guide host nerve regeneration; immunosuppressive medication is required for only a couple of years, and long-term allograft survival is not relevant. On the basis of the experience in organ transplantation, chronic rejection remains a significant and unsolved problem despite the use of the most potent immunosuppressive drugs. Since composite tissue transplantation improves quality of life but is nonvital, allograft longevity will continue to be a critical issue in the justification of hand and face transplantation.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Washington University School of Medicine, St. Louis, Missouri

    Thomas H. Tung (Assistant Professor of Surgery)

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Editors and Affiliations

  1. Division of Surgical Research UMDNJ-Robert Wood Johnson Medicine Medical School, Cooper University Hospital, Camden, New Jersey

    Charles W. Hewitt (Professor of Surgery Head) (Professor of Surgery Head)

  2. Division of Plastic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

    W. P. Andrew Lee (Professor of Surgery and Orthopedic Surgery Chief) (Professor of Surgery and Orthopedic Surgery Chief)

  3. Department of Surgery UMDNJ-Robert Wood Johnson Medical School, Cooper University Hospital, Camden, New Jersey

    Chad R. Gordon (Chief Resident) (Chief Resident)

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Tung, T.H. (2008). Long-Term Prevention of Rejection and Combination Drug Therapy. In: Hewitt, C.W., Lee, W.P.A., Gordon, C.R. (eds) Transplantation of Composite Tissue Allografts. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-74682-1_11

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