title: Achievements and challenges in composite tissue allotransplantation.
abstract: Overall, more than 60 hand/forearm/arm transplantations and 16 face transplantations have been performed in the past 12 years. In the European experience summarized here, three grafts have been lost in response to a vascular thrombosis (n = 1), rejection and incompliance with immunosuppression (n = 1) and death (n = 1). The overall functional and esthetic outcome is very satisfactory, but serious side effects and complications related to immunosuppression are challenges hindering progress in this field. The high levels of immunosuppression, skin rejection, nerve regeneration, donor legislation and the acceptance level need to be addressed to promote growth of this promising new field in transplantation and reconstructive surgery.
authors.affiliation: Center for Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria. stefan.schneeberger@i-med.ac.at
authors.forename: Stefan
authors.initials: S
authors.lastname: Schneeberger
authors.forename: Luis
authors.initials: L
authors.lastname: Landin
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jableki
authors.forename: Peter
authors.initials: P
authors.lastname: Butler
authors.forename: Christoph
authors.initials: C
authors.lastname: Hoehnke
authors.forename: Gerald
authors.initials: G
authors.lastname: Brandacher
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Morelon
mesh_terms: D001132:Arm / Q000637:transplantation*; D005060:Europe; D054445:Facial Transplantation / Q000379:methods*; D005260:Female; D006084:Graft Rejection; D063987:Hand Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D008297:Male; D013927:Thrombosis / Q000473:pathology; D014181:Transplantation Immunology; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome