Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages
As clinical experience with surgical techniques and immunosuppression in vascularized composite allotransplantation recipients has accumulated, vascularized composite allotransplantation for hand and face have become standard of care in some countries for select patients who have experienced catastr...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-10-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/2050312120968721 |
| _version_ | 1818308539842560000 |
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| author | Yoram Y Fleissig Jason E Beare Amanda J LeBlanc Christina L Kaufman |
| author_facet | Yoram Y Fleissig Jason E Beare Amanda J LeBlanc Christina L Kaufman |
| author_sort | Yoram Y Fleissig |
| collection | DOAJ |
| description | As clinical experience with surgical techniques and immunosuppression in vascularized composite allotransplantation recipients has accumulated, vascularized composite allotransplantation for hand and face have become standard of care in some countries for select patients who have experienced catastrophic tissue loss. Experience to date suggests that clinical vascularized composite allotransplantation grafts undergo the same processes of allograft rejection as solid organ grafts. Nonetheless, there are some distinct differences, especially with respect to the immunologic influence of the skin and how the graft is affected by environmental and traumatic insults. Understanding the mechanisms around these similarities and differences has the potential to not only improve vascularized composite allotransplantation outcomes but also outcomes for all types of transplants and to contribute to our understanding of how complex systems of immunity and function work together. A distinct disadvantage in the study of upper extremity vascularized composite allotransplantation recipients is the low number of clinical transplants performed each year. As upper extremity transplantation is a quality of life rather than a lifesaving transplant, these numbers are not likely to increase significantly until the risks of systemic immunosuppression can be reduced. As such, experimental models of vascularized composite allotransplantation are essential to test hypotheses regarding unique characteristics of graft rejection and acceptance of vascularized composite allotransplantation allografts. Rat hind limb vascularized composite allotransplantation models have been widely used to address these questions and provide essential proof-of-concept findings which can then be extended to other experimental models, including mice and large animal models, as new concepts are translated to the clinic. Here, we review the large body of rat hind limb vascularized composite allotransplantation models in the literature, with a focus on the various surgical models that have been developed, contrasting the characteristics of the specific model and how they have been applied. We hope that this review will assist other researchers in choosing the most appropriate rat hind limb transplantation model for their scientific interests. |
| first_indexed | 2024-12-13T07:15:53Z |
| format | Article |
| id | doaj.art-c16fac86ccb3444c87ffaaa09286ea81 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-12-13T07:15:53Z |
| publishDate | 2020-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-c16fac86ccb3444c87ffaaa09286ea812022-12-21T23:55:34ZengSAGE PublishingSAGE Open Medicine2050-31212020-10-01810.1177/2050312120968721Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantagesYoram Y Fleissig0Jason E Beare1Amanda J LeBlanc2Christina L Kaufman3Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY, USAThe Cardiovascular Innovation Institute, The University of Louisville, Louisville, KY, USAThe Cardiovascular Innovation Institute, The University of Louisville, Louisville, KY, USADepartment of Cardiovascular and Thoracic Surgery, The University of Louisville, Louisville, KY, USAAs clinical experience with surgical techniques and immunosuppression in vascularized composite allotransplantation recipients has accumulated, vascularized composite allotransplantation for hand and face have become standard of care in some countries for select patients who have experienced catastrophic tissue loss. Experience to date suggests that clinical vascularized composite allotransplantation grafts undergo the same processes of allograft rejection as solid organ grafts. Nonetheless, there are some distinct differences, especially with respect to the immunologic influence of the skin and how the graft is affected by environmental and traumatic insults. Understanding the mechanisms around these similarities and differences has the potential to not only improve vascularized composite allotransplantation outcomes but also outcomes for all types of transplants and to contribute to our understanding of how complex systems of immunity and function work together. A distinct disadvantage in the study of upper extremity vascularized composite allotransplantation recipients is the low number of clinical transplants performed each year. As upper extremity transplantation is a quality of life rather than a lifesaving transplant, these numbers are not likely to increase significantly until the risks of systemic immunosuppression can be reduced. As such, experimental models of vascularized composite allotransplantation are essential to test hypotheses regarding unique characteristics of graft rejection and acceptance of vascularized composite allotransplantation allografts. Rat hind limb vascularized composite allotransplantation models have been widely used to address these questions and provide essential proof-of-concept findings which can then be extended to other experimental models, including mice and large animal models, as new concepts are translated to the clinic. Here, we review the large body of rat hind limb vascularized composite allotransplantation models in the literature, with a focus on the various surgical models that have been developed, contrasting the characteristics of the specific model and how they have been applied. We hope that this review will assist other researchers in choosing the most appropriate rat hind limb transplantation model for their scientific interests.https://doi.org/10.1177/2050312120968721 |
| spellingShingle | Yoram Y Fleissig Jason E Beare Amanda J LeBlanc Christina L Kaufman Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages SAGE Open Medicine |
| title | Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages |
| title_full | Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages |
| title_fullStr | Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages |
| title_full_unstemmed | Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages |
| title_short | Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages |
| title_sort | evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation approaches and advantages |
| url | https://doi.org/10.1177/2050312120968721 |
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