Impact of donor-specific antibodies in reconstructive transplantation.
For many devastating injuries and tissue defects where conventional reconstruction is not possible, reconstructive transplantation such as hand and face transplantation has become a viable alternative. This novel approach allows for improved restoration of appearance, anatomy and function not feasible by other available treatment options. However, clinical management of these injuries prior to transplantation frequently requires multiple blood transfusion or skin grafts resulting in the formation of alloantibodies (anti-HLA IgG Abs) and a high degree of sensitization. The role of donor-specific antibodies (DSA) and mechanisms of antibody-mediated rejection (AMR) in reconstructive transplantation are still largely unknown. Thus there is an imminent need to develop a better understanding of the mechanisms related to DSA and AMR after reconstructive transplantation. In this review, we will define the role of DSA and mechanisms of AMR in reconstructive transplantation and compare them to established measures and treatment concepts in solid organ transplantation.
Department of Plastic and Reconstructive Surgery, Vascularized Composite Allotransplantation (VCA) Laboratory, Johns Hopkins University School of Medicine, Ross Research Building 749D, 720 Rutland Avenue, Baltimore, MD, 21205 USA.
Angelo A
AA
Leto Barone
Zhaoli
Z
Sun
Robert A
RA
Montgomery
W P Andrew
WP
Lee
Gerald
G
Brandacher
D000818:Animals; D058846:Antibodies, Monoclonal, Murine-Derived; D000920:Antibody-Dependent Cell Cytotoxicity; D006084:Graft Rejection / Q000276:immunology* / Q000517:prevention & control; D006801:Humans; D007167:Immunotherapy; D007518:Isoantibodies / Q000276:immunology*; D015166:Monitoring, Immunologic; D016377:Organ Transplantation; D019651:Plastic Surgery Procedures; D000069283:Rituximab
D058846:Antibodies, Monoclonal, Murine-Derived; D007518:Isoantibodies; D000069283:Rituximab