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Tolerance Protocols in Large Animal VCA Models—Comprehensive Review

  • Vascularized Composite Allografts (V Gorantla, Section Editor)
  • Published:
Current Transplantation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The clinical application of vascularized composite allografts (VCA) has continue to expand each year as new transplants are performed. However, chronic rejection and the many side effects from chronic immunosuppression continue to inhibit widespread application of VCA. Immune tolerance to VCA would address these two issues and shift the risk-benefit ratio to allow for the more widespread application of these transplants. Future development of clinical tolerance protocols will be generated from pre-clinical experiments performed in large animal models. This article reviews the current state of large animal tolerance protocols published for VCA.

Recent Findings

The most successful tolerance protocols thus far include the use of hematopoietic stem cell transplant with non-myeloablative preconditioning and establishment of donor cell chimerism. In addition to this strategy, several groups have examined the inclusion of mesenchymal and adipose-derived stem cells to address the complications related to the use of hematopoietic stem cell transplant (such as graft versus host disease).

Summary

These large animal models are critical to development of a viable pre-clinical model for tolerance in vascularized composite allografts that can deliver a tolerant state with minimal harm to the recipient of these non-life-saving transplants.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado, Anschutz Medical Center, 12631 East 17th Avenue (Mail Stop C309), Academic Office 1, 6th Floor, Room 6511, Aurora, CO, 80045, USA

    Ariel C. Johnson, Christene A. Huang & David W. Mathes

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  1. Ariel C. Johnson
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  2. Christene A. Huang
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  3. David W. Mathes
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Ariel C. Johnson. Formal material analysis and investigation were performed by Christene A. Huang and David W. Mathes. The first draft of the manuscript was written by Ariel C. Johnson, and reviewing and editing were completed by Christene A. Huang and David W. Mathes. All authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to David W. Mathes.

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None of the authors have a financial interest in any of the products, devices or drugs mentioned in this article.

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This article is part of the Topical collection on Vascularized Composite Allografts

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Johnson, A.C., Huang, C.A. & Mathes, D.W. Tolerance Protocols in Large Animal VCA Models—Comprehensive Review. Curr Transpl Rep 7, 270–278 (2020). https://doi.org/10.1007/s40472-020-00302-1

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