Grasping time - longevity of vascularized composite allografts
- PMID: 39470048
- DOI: 10.1097/MOT.0000000000001177
Grasping time - longevity of vascularized composite allografts
Abstract
Purpose of review: Despite significant advancements in the field of vascularized composite allotransplantation, challenges, particularly regarding the long-term viability and functionality of vascularized composite allotransplantation (VCA) grafts, persist. This paper provides a review of the current literature on the longevity of VCA grafts, focusing on factors influencing graft survival, immunological considerations and clinical outcomes.
Recent findings: Longevity of VCA grafts is influenced by a variety of peri- and postoperative factors including cold ischemia time, human leukocyte antigen matching, environmental exposure, psychosocial factors, adherence, immunosuppression, and complications. Due to the limited number of VCA transplants performed and heterogenous reporting, direct correlation of single factors with VCA outcomes remains inconclusive. Indirect evidence, however, supports their importance. High immunosuppressive burden, frequent occurrence of acute and accumulating cases of chronic rejection remain a significant challenge of the field.
Summary: Insights gained from this review aim to inform clinical practice and guide future research endeavors with the goal of ameliorating outcomes after VCA transplantation and facilitate wider use of VCA grafts for restoration of tissue defects.
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
References
-
- Poggio ED, Augustine JJ, Arrigain S, et al. Long-term kidney transplant graft survival—making progress when most needed. Am J Transplant 2021; 21:2824–2832.
-
- Studer SM, Levy RD, McNeil K, Orens JB. Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness. Eur Respir J 2004; 24:674–685.
-
- IRHCTT – International Registry on Hand and Composite Tissue Transplantation. n.d. https://www.handregistry.com/ [Accessed August 10, 2024].
-
- Gurunian R, Rampazzo A, Papay F, Gharb BB. Reconstructive transplantation. Cham: Springer; 2023.
-
- Wells MW, Rampazzo A, Papay F, Gharb BB. Two decades of hand transplantation: a systematic review of outcomes. Ann Plast Surg 2022; 88:335–344.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Research Materials
