Hand Transplantation

pp 61-77

Experimental Approaches to Composite Tissue Allograft Transplants

  • Maria SiemionowAffiliated withDepartment of Plastic Surgery, The Cleveland Clinic Foundation
  • , Yalcin KulahciAffiliated withDepartment of Plastic Surgery, The Cleveland Clinic Foundation

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Composite tissue allotransplantation has been recently introduced as a potential clinical treatment for complex reconstructive procedures, include traumatic injuries, cancer ablative surgeries, or extensive tissue loss secondary to burns. Composite tissue allografts (CTAs) consist of heterogeneous tissues derived from ectoderm and mesoderm, including skin, fat, muscle, nerves, lymph nodes, bone, cartilage, ligaments, and bone marrow, with different antigenicity. Thus, composite tissue structure is considered to be more immunogenic than solid organ transplants. While cartilage, ligaments, and fat present low antigenicity, bone, muscles, nerves, and vessels present moderate antigenicity, and skin is the component that develops the most severe rejection because of the abundance of dendritic cells within the epidermis and dermis. To study the mechanisms of CTA acceptance and rejection, different experimental models, strategies and different immunosuppressive protocols have used [1, 2].