Non-invasive Monitoring of Skin-Containing Vascularized Composite Allotransplantation

Chapter

Abstract

Monitoring of allograft rejection is critical to be able to provide proper immunosuppressive treatment following allotransplantation. Skin biopsy is needed to prove and to grade of rejection according to the current protocols, but it is an invasive and time-consuming method. An experimental study was performed to describe a non-invasive monitoring of allograft rejection. Five skin-containing vascularized composite allotransplantations were performed on rats, and allograft rejection was evaluated with reflectance confocal microscopy and also with skin biopsy. All data obtained from the study were evaluated and compared statistically. Reflectance confocal microscopy is presented as a new non-invasive rejection monitoring technique, and the new allograft rejection scoring system is recommended based on the results of this experimental study in this chapter.

Keywords

Monitoring Reflectance confocal microscopy Rejection Scoring Vascularized composite allotransplantation 

References

  1. 1.
    Murray JE. Organ transplantation (skin, kidney, heart) and the plastic surgeon. Plast Reconstr Surg. 1971;47(5):425–31.PubMedCrossRefGoogle Scholar
  2. 2.
    Lee WP, Yaremchuk MJ, Pan YC, Randolph MA, Tan CM, Weiland AJ. Relative antigenicity of components of a vascularized limb allograft. Plast Reconstr Surg. 1991;87(3):401–11.PubMedCrossRefGoogle Scholar
  3. 3.
    Cendales LC, Breidenbach 3rd WC. Hand transplantation. Hand Clin. 2001;17(3):499–510, x.PubMedGoogle Scholar
  4. 4.
    Cendales LC, Kanitakis J, Schneeberger S, Burns C, Ruiz P, Landin L, et al. The Banff 2007 working classification of skin-containing composite tissue allograft pathology. Am J Transplant. 2008;8(7):1396–400.PubMedCrossRefGoogle Scholar
  5. 5.
    Petruzzo P, Lanzetta M, Dubernard JM, Landin L, Cavadas P, Margreiter R, et al. The international registry on hand and composite tissue transplantation. Transplantation. 2010;90(12):1590–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Cendales LC, Kirk AD, Moresi JM, Ruiz P, Kleiner DE. Composite tissue allotransplantation: classification of clinical acute skin rejection. Transplantation. 2005;80(12):1676–80.PubMedGoogle Scholar
  7. 7.
    Ravindra KV, Buell JF, Kaufman CL, Blair B, Marvin M, Nagubandi R, et al. Hand transplantation in the United States: experience with 3 patients. Surgery. 2008;144(4):638–43; discussion 43–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Hofmann-Wellenhof R, Wurm EM, Ahlgrimm-Siess V, Richtig E, Koller S, Smolle J, et al. Reflectance confocal microscopy – state-of-art and research overview. Semin Cutan Med Surg. 2009;28(3):172–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Petruzzo P, Kanitakis J, Badet L, Pialat JB, Boutroy S, Charpulat R, et al. Long-term follow-up in composite tissue allotransplantation: in-depth study of five (hand and face) recipients. Am J Transplant. 2011;11(4):808–16.PubMedCrossRefGoogle Scholar
  10. 10.
    Kanitakis J. The challenge of dermatopathological diagnosis of composite tissue allograft rejection: a review. J Cutan Pathol. 2008;35(8):738–44.PubMedCrossRefGoogle Scholar
  11. 11.
    Astner S, Gonzalez E, Cheung A, Rius-Diaz F, Gonzalez S. Pilot study on the sensitivity and specificity of in vivo reflectance confocal microscopy in the diagnosis of allergic contact dermatitis. J Am Acad Dermatol. 2005;53(6):986–92.PubMedCrossRefGoogle Scholar
  12. 12.
    Basaran YK, Gurel MS, Erdemir AT, Turan E, Yurt N, Bagci IS. Evaluation of the response to treatment of psoriasis vulgaris with reflectance confocal microscopy. Skin Res Technol. 2014. doi:  10.1111/srt.12150. [Epub ahead of print].

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Huseyin Karagoz
    • 1
  • Mehmet Salih Gurel
    • 2
  • Fatih Zor
    • 3
  1. 1.Department of Plastic and Reconstructive SurgeryGulhane Military Medical Academy, Haydarpasa Training HospitalIstanbulTurkey
  2. 2.Department of DermatologyIstanbul Training and Research HospitalIstanbulTurkey
  3. 3.Department of Plastic and Reconstructive SurgeryGulhane Military Medical AcademyAnkaraTurkey

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