Hand transplantation and vascularized composite tissue allografts in orthopaedics and traumatology.
Composite tissue allograft (CTA) is defined as heterologous transplantation of a complex comprising skin and subcutaneous, neurovascular and mesenchymal tissue. Such techniques allow complex reconstruction using matched tissue, without donor site morbidity. The potential indications in orthopaedics-traumatology could in the future be more frequent than the present indications of heart, lung, liver, kidney and pancreas transplantation. International clinical experience clearly demonstrates the feasibility of CTA, both surgically and immunologically. However, immunosuppression remains indispensable, exposing the patient to risks that are not acceptable for purely functional surgery, except in very particular indications. The main hope for the future lies in induction of graft-specific tolerance.
Schuind
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Department of Orthopaedics and Traumatology, Erasme University Hospital, Université libre de Bruxelles, 808 route de Lennik, 1070 Brussels, Belgium. frederic.schuind@erasme.ulb.ac.be
D000818:Animals; D006084:Graft Rejection; D006085:Graft Survival; D006225:Hand / Q000098:blood supply; D063987:Hand Transplantation; D006801:Humans; D009985:Orthopedics / Q000379:methods*; D023001:Transplantation Tolerance; D014184:Transplantation, Homologous / Q000379:methods*; D014194:Traumatology / Q000379:methods*