title: Chest wall, thymus, and heart vascularized composite allograft proof of concept cadaveric model for heart transplantation.
abstract: The use of vascularized composite allografts allows for the reconstruction of complex scenarios that previously have required multistaged operations. Heart transplantation often follows a series of previous operations leading to chest wall deformities and significant mediastinal adhesions that can limit the use of larger hearts, making it difficult to find a suitable donor. Further, research has shown that the use of vascularized bone marrow and vascularized thymus in transplantation potentially prolongs graft survival with decreased immunosuppression requirements. The authors propose using a vascularized composite allograft of the chest wall consisting of sternum and thymus in conjunction with the heart for cardiac transplantation to allow for more flexibility from the donor pool, maintain chest wall integrity and physiology, and potentially immunoregulate the concomitant solid organ transplant.
authors.affiliation: From the *University of Maryland School of Medicine; †Department of Plastic and Reconstructive Surgery, Johns Hopkins Medical Institute, Baltimore, MD; and ‡Section of Plastic and Reconstructive Surgery, University of Chicago Medical Center, Chicago, IL.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Schultz
authors.forename: Raja
authors.initials: R
authors.lastname: Mohan
authors.forename: Amir H
authors.initials: AH
authors.lastname: Dorafshar
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Gottlieb
mesh_terms: D064595:Composite Tissue Allografts; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D035441:Thoracic Wall / Q000601:surgery*