title: Pathological score for the evaluation of allograft rejection in human hand (composite tissue) allotransplantation.
abstract: The experience obtained from the human hand allografts (HHA) performed to date suggests that the skin is a priviledged target of allograft rejection in this setting. The aim of this study was to establish a pathological score for assessing the severity of HHA rejection. The pathological slides of 89 skin biopsies obtained from the allografted limbs of six HHA recipients from day 0 to 5 years post-graft were retrospectively examined. According to the severity of the pathological changes observed, the following grades of rejection are proposed: 0: no rejection, I: mild rejection, II: moderate rejection, III: severe rejection, IV: very severe rejection. This grading system can be used as a basis for monitoring allograft rejection and for assessing the effects of the immunosuppressive treatment aiming at reversing HHA rejection; it can also be used for monitoring rejection of other skin-containing CTA.
authors.affiliation: Department of Dermatology/EA 37-32 UCBL, Ed. Herriot Hospital, Lyon, France. jean.kanitakis@chu-lyon.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Kanitakis
authors.forename: Palmina
authors.initials: P
authors.lastname: Petruzzo
authors.forename: Denis
authors.initials: D
authors.lastname: Jullien
authors.forename: Lionel
authors.initials: L
authors.lastname: Badet
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Dezza
authors.forename: Alain
authors.initials: A
authors.lastname: Claudy
authors.forename: Marco
authors.initials: M
authors.lastname: Lanzetta
authors.forename: Nadey
authors.initials: N
authors.lastname: Hakim
authors.forename: Earl
authors.initials: E
authors.lastname: Owen
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Dubernard
mesh_terms: D000328:Adult; D006084:Graft Rejection / Q000473:pathology*; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013524:Surgical Flaps