title: Immunobiology in VCA.
abstract: Transplantation of vascularized composite tissue is a relatively new field that is an amalgamation of experience in solid organ transplantation and reconstructive plastic and orthopedic surgery. What is novel about the immunobiology of VCA is the addition of tissues with unique immunologic characteristics such as skin and vascularized bone, and the nature of VCA grafts, with direct exposure to the environment, and external forces of trauma. VCAs are distinguished from solid organ transplants by the requirement of rigorous physical therapy for optimal outcomes and the fact that these procedures are not lifesaving in most cases. In this review, we will discuss the immunobiology of these systems and how the interplay can result in pathology unique to VCA as well as provide potential targets for therapy.
authors.affiliation: Christine M. Kleinert Institute, Louisville, KY, USA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Kaufman
authors.affiliation: Jewish Hospital Transplant Center, Louisville, KY, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Marvin
authors.affiliation: Christine M. Kleinert Institute, Louisville, KY, USA.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Chilton
authors.affiliation: Cardiovascular Innovation Institute, Louisville, KY, USA.
authors.forename: James B
authors.initials: JB
authors.lastname: Hoying
authors.affiliation: Cardiovascular Innovation Institute, Louisville, KY, USA.
authors.forename: Stuart K
authors.initials: SK
authors.lastname: Williams
authors.affiliation: Christine M. Kleinert Institute, Louisville, KY, USA.
authors.forename: Huey
authors.initials: H
authors.lastname: Tien
authors.affiliation: Christine M. Kleinert Institute, Louisville, KY, USA.
authors.forename: Tuna
authors.initials: T
authors.lastname: Ozyurekoglu
authors.affiliation: Kidney Disease Program, University of Louisville, Louisville, KY, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Ouseph
mesh_terms: D000818:Animals; D001842:Bone and Bones / Q000276:immunology; D006084:Graft Rejection / Q000276:immunology; D063987:Hand Transplantation / Q000379:methods; D006801:Humans; D007107:Immune System; D007108:Immune Tolerance; D012867:Skin / Q000276:immunology; D016038:Skin Transplantation / Q000379:methods; D013518:Surgery, Plastic / Q000379:methods; D014184:Transplantation, Homologous; D063986:Vascularized Composite Allotransplantation / Q000379:methods*
keywords: T regulatory cells; face transplantation; hand transplantation; immunomodulation; vasculopathy