Abstract
The optimal immunosuppressive regimen for initial, maintenance and rejection therapy after hand transplantation has not yet been identified. Composite tissue allograft (CTA), such as hand transplantation, has been performed only experimentally for many years because of the skin’s high degree of immunogenicity. Indeed, it was assumed that the dosage of immunosuppressive drugs required to prevent rejection were too high to be used safely in the clinical setting. Advances in immunopharmacology and the encouraging results achieved in animal models [1]–[3] in this last decade allowed the realization of different human CTAs, including larynx, knee, hand and part of a face. These positive outcomes have been made possible through the use of the latest induction and maintenance regimens.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Perez-Abadia G, Laurentin-Perez L, Gorantla VS et al (2003) Low-dose immunosuppression in a rat hindlimb transplantation model. Transpl Int 16:835–842
Jones JW Jr, Ustuner ET, Zdichavsky M et al (1999) Long-term survival of an extremity composite tissue allograft with FK 506-mycophenolate mofetil therapy. Surgery 126:384–388
Ustuner ET, Zdichavsky M, Ren X et al (1998) Longterm composite tissue allograft survival in a porcine model with cyclosporine/mycophenolate mofetil. Transplantation 66:1581–1587
Halloran PF, Lui SL (1998) Approved immunosuppressants. In: Norman DJ, Suki WN (eds) Primer on transplantation. American Society of Transplant Physicians, Thorofare, pp 93–102
Najarian JS, Simmons RL, Condic RM et al (1976) Seven years’ experience with antilymphoblast globulin for renal transplantation from cadaver donors. Ann Surg 184:352–368
Hardy MA (1982) Beneficial effects of heterologous antilymphoid globulins in renal transplantation: one “believer’s view”. Am J Kidney Dis 2:79–86
Fenton SS, Tober JA, Cardella CJ (1994) A comparison of rabbit antithymocyte serum and OKT3, as prophylaxis against renal allograft rejection. Transplantation 57:60–67
Vincenti F, Kirkman R, Light S et al (1998) Interleukin-2 blockade with Daclizumab to prevent acute rejection in renal transplantation. Daclizumab Triple Therapy Study Group. N Engl J Med 338:161–165
Lan NC, Karin M, Nguyen T et al (1984) Mechanisms of glucocorticoid hormone action. J Steroid Biochem 20:77–88
Borel JF (1981) Cyclosporin-A — present experimental status. Transplant Proc 13:344–348
Land W (1988) Cyclosporine in cadaveric renal transplantation: five year follow-up results of the European Multicentric Trial. Transplant Proc 20:73–77
Goto T, Kino T, Hatanaka H et al (1987) Discovery of FK 506, a novel immunosuppressant, isolated from Streptomices tsukubaensis. Transplant Proc 19:4–8
Suzuki N, Sakane T, Tsunematsu T (1990) Effects of a novel immunosuppressive agent, FK 506 on human B-cell activation. Clin Exp Immunol 79:240–245
Ransom JT (1995) Mechanism of action of Mycophenolate Mofetil. Ther Drug Monit 17:681–684
The Tricontinental Mycophenolate Mofetil Study Group (1998) A blinded long-term, randomised study of mycophenolate mofetil in cadaveric renal transplantation: results at three years. Transplantation 65:1450–1454
Vezina C, Kudelski A, Sehgal SN (1975) Rapamycin (AY-22989), a new antifungal antibiotic: taxonomy of the producing streptomycete and isolation of the active principle. J Antibiot 28:721–732
Lai JH, Tan H (1994) CD28 signaling causes a sustained down-regulation of I kappa B alpha which can be prevented by the immunosuppressant rapamycin. J Biol Chem 269:30077–30080
Lanzetta M, Petruzzo P, Margreiter R et al (2005) The International Registry on Hand and Composite Tissue Transplantation. Transplantation. 79:1210–1214
Michallet MC, Preville X, Flacher L et al (2003) Functional antibodies to leukocyte adhesion molecules in antithymocyte globulins. Transplantation 75:657–662
Genestier L, Fournel L, Flacher M et al (1998) Induction of Fas (Apo-1, CD95)-mediated apoptosis of activa Blood 91:2360–2368
Harris PE, Kendall-Taylor P (1989) Steroid therapy and surgery. Curr Pract Surg 11:277–285
Barbul A, Breslin RJ, Woodyard JP et al (1989) The effect of in-vivo T-helper and T-suppressor lymphocyte depletion on wound healing AA Surg 209:479–483
Pirsch JD, Miller J, Deierhoi MH et al (1997) A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group. Transplantation 63:977–983
Gold BG, Yew JY, Zeleny-Pooley M (1998) The immunosuppressant FK506 increases GAP-43 mRNA levels in axotomized sensory neurons. Neurosci Lett 241:25–28
Gabl M, Pechlaner S, Lutz M et al (2004) Bilateral hand transplantation: bone healing under immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone. J Hand Surg [Am] 29:1020–1027
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer-Verlag Italia
About this chapter
Cite this chapter
Petruzzo, P. (2007). Induction and Maintenance Therapy. In: Lanzetta, M., Dubernard, JM., Petruzzo, P. (eds) Hand Transplantation. Springer, Milano. https://doi.org/10.1007/978-88-470-0374-3_27
Download citation
DOI: https://doi.org/10.1007/978-88-470-0374-3_27
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0373-6
Online ISBN: 978-88-470-0374-3
eBook Packages: MedicineMedicine (R0)