CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT
Introduction. The field of composite tissue allotransplatation became a clinical reality since first hand transplant performed in 1998 at Lyon, France and has been progressing over the past two decades. Vascularized composite allotransplantation (VCA) is now performed for life enhancing indications...
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| Format: | Article |
| Language: | English |
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Amaltea Medical Publishing House
2019-09-01
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| Series: | Romanian Journal of Medical Practice |
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| Online Access: | https://revistemedicale.amaltea.ro/Romanian_Journal_of_MEDICAL_PRACTICE/Practica_medicala-2019-Nr.3/RJMP_2019_3_Art-11.pdf |
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| author | Andreea Grosu-Bularda Ioan Lascăr Răzvan Nicolae Teodoreanu |
| author_facet | Andreea Grosu-Bularda Ioan Lascăr Răzvan Nicolae Teodoreanu |
| author_sort | Andreea Grosu-Bularda |
| collection | DOAJ |
| description | Introduction. The field of composite tissue allotransplatation became a clinical reality since first hand
transplant performed in 1998 at Lyon, France and has been progressing over the past two decades. Vascularized composite allotransplantation (VCA) is now performed for life enhancing indications in a selected
group of patients under institutional protocols.
Aim. This paper is an attempt to review the outcomes of VCA to date.
Method. Analysis of relevant publications of composite tissue allotransplantation was performed, including the International Registry on Hand and Composite Tissue Transplantation (IRHCTT).
Results and discussion. To date, there are more than 200 composite tissue allograft transplants performed worldwide, including upper limb, face, larynx, trachea, abdominal wall, lower limb, penis, and
uterus. The technical aspects of VCA are no longer the factors limiting the widespread application of this
treatment modality in the clinical setting. The feasibility of the procedure has been established, and the functional outcomes have been very good so far. The major challenge is at the immunologic level, long-term goal
being to promote donor-specific tolerance and to avoid the toxicity of immunosuppression.
Conclusions. Vascularized composite allografts transplatation is a viable treatment option well on the
way of becoming a standard of care for those who have lost extremities and suffered large tissue defects. The
initial ethical dilemmas and concerns of safety and feasibility have been overcome recently and with further
standardized surgical and immunological protocols the field is likely to grow significantly in the future. |
| first_indexed | 2024-12-21T03:17:41Z |
| format | Article |
| id | doaj.art-d1b05924e71e4165a9d8738ba7c1706f |
| institution | Directory Open Access Journal |
| issn | 1842-8258 2069-6108 |
| language | English |
| last_indexed | 2024-12-21T03:17:41Z |
| publishDate | 2019-09-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Journal of Medical Practice |
| spelling | doaj.art-d1b05924e71e4165a9d8738ba7c1706f2022-12-21T19:17:48ZengAmaltea Medical Publishing HouseRomanian Journal of Medical Practice1842-82582069-61082019-09-0114326727610.37897/RJMP.2019.3.11CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANTAndreea Grosu-Bularda0Ioan Lascăr1Răzvan Nicolae Teodoreanu2Spitalul Clinic de Urgenţă, Bucureşti, RomâniaSpitalul Clinic de Urgenţă, Bucureşti, România; Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, RomâniaSpitalul Clinic de Urgenţă, Bucureşti, România; Universitatea de Medicină şi Farmacie „Carol Davila“, Bucureşti, RomâniaIntroduction. The field of composite tissue allotransplatation became a clinical reality since first hand transplant performed in 1998 at Lyon, France and has been progressing over the past two decades. Vascularized composite allotransplantation (VCA) is now performed for life enhancing indications in a selected group of patients under institutional protocols. Aim. This paper is an attempt to review the outcomes of VCA to date. Method. Analysis of relevant publications of composite tissue allotransplantation was performed, including the International Registry on Hand and Composite Tissue Transplantation (IRHCTT). Results and discussion. To date, there are more than 200 composite tissue allograft transplants performed worldwide, including upper limb, face, larynx, trachea, abdominal wall, lower limb, penis, and uterus. The technical aspects of VCA are no longer the factors limiting the widespread application of this treatment modality in the clinical setting. The feasibility of the procedure has been established, and the functional outcomes have been very good so far. The major challenge is at the immunologic level, long-term goal being to promote donor-specific tolerance and to avoid the toxicity of immunosuppression. Conclusions. Vascularized composite allografts transplatation is a viable treatment option well on the way of becoming a standard of care for those who have lost extremities and suffered large tissue defects. The initial ethical dilemmas and concerns of safety and feasibility have been overcome recently and with further standardized surgical and immunological protocols the field is likely to grow significantly in the future.https://revistemedicale.amaltea.ro/Romanian_Journal_of_MEDICAL_PRACTICE/Practica_medicala-2019-Nr.3/RJMP_2019_3_Art-11.pdftransplantationvascularized composite allotransplantation (vca)hand transplantationface transplantationimmunosuppression |
| spellingShingle | Andreea Grosu-Bularda Ioan Lascăr Răzvan Nicolae Teodoreanu CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT Romanian Journal of Medical Practice transplantation vascularized composite allotransplantation (vca) hand transplantation face transplantation immunosuppression |
| title | CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT |
| title_full | CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT |
| title_fullStr | CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT |
| title_full_unstemmed | CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT |
| title_short | CURRENT STATUS OF VASCULARIZED COMPOSITE ALLOGRAFTS TRANSPLANT |
| title_sort | current status of vascularized composite allografts transplant |
| topic | transplantation vascularized composite allotransplantation (vca) hand transplantation face transplantation immunosuppression |
| url | https://revistemedicale.amaltea.ro/Romanian_Journal_of_MEDICAL_PRACTICE/Practica_medicala-2019-Nr.3/RJMP_2019_3_Art-11.pdf |
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