RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.4103/0970-0358.163037
Vascularised composite allotransplants: Transplant of upper extremities and face
Publikationsverlauf
Publikationsdatum:
26. August 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00042863/201502/lookinside/thumbnails/10-4103-0970-0358-163037_00111-1.jpg)
ABSTRACT
Transplantation of solid organs and bone marrow has become a highly acceptable and often the only available clinical solution in many situations. It has been practiced across the globe for quite a long time since the first kidney transplant in 1954. Transplantation of tissues other than these, which was termed composite tissue allotransplantation and currently as vascularised composite allotransplantation (VCA) is gaining acceptance as a solution for complex reconstructive problems. This involves the transfer of multiple types of tissue such as bone, muscle, nerve, skin and blood vessels. The advantage of these over the conventional reconstructive methods is its ability to give aesthetically and functionally superior equal composite substitute to the missing or deformed part. The composite tissues transplanted commonly include the upper extremities, face and abdominal wall. Among these, hand transplants were the first to be done and have been carried out more than any other VCA. This article reviews the current scenario of VCA especially of the hand and face, in the light of experience of the two bilateral hand transplants done recently in India.
-
REFERENCES
- 1 Harrison JH, Merrill JP, Murray JE. Renal homotransplantation in identical twins. Surg Forum 1956; 6: 432-6
- 2 Merrill JP, Murray JE, Harrison JH, Guild WR. Successful homotransplantation of the human kidney between identical twins. J Am Med Assoc 1956; 160: 277-82
- 3 Peacock Jr EE. Restoration of finger flexion with homologous composite tissue tendon grafts of the digital flexor mechanism in human beings. Trans Bull 1960; 7: 418
- 4 Gilbert R. Transplant is successful with cadaver forearm. Med Trib Med News 1964; 5: 20
- 5 Gilbert R. Hand transplanted from cadaver is reamputated. Med Trib Med News 1964; 5: 23
- 6 Dubernard JM, Owen E, Herzberg G, Lanzetta M, Martin X, Kapila H. et al. Human hand allograft: Report on first 6 months. Lancet 1999; 353: 1315-20
- 7 Duquesnoy RJ. Is histocompatibility testing needed for composite tissue transplantation?. Transplant Proc 1998; 30: 2724-8
- 8 Schneeberger S, Gorantla VS, Brandacher G, Zeevi A, Demetris AJ, Lunz JG. et al. Upper-extremity transplantation using a cell-based protocol to minimize immunosuppression. Ann Surg 2013; 257: 345-51
- 9 Gorantla VS, Brandacher G, Schneeberger S, Zheng XX, Donnenberg AD, Losee JE. et al. Favoring the risk-benefit balance for upper extremity transplantation - the Pittsburgh protocol. Hand Clin 2011; 27: 511-20 ix-x
- 10 Gorantla VS, Demetris AJ. Acute and chronic rejection in upper extremity transplantation: What have we learned?. Hand Clin 2011; 27: 481-93 ix
- 11 Cendales LC, Kanitakis J, Schneeberger S, Burns C, Ruiz P, Landin L. et al. The Banff 2007 working classification of skin-containing composite tissue allograft pathology. Am J Transplant 2008; 8: 1396-400
- 12 Petruzzo P, Lanzetta M, Dubernard JM, Landin L, Cavadas P, Margreiter R. et al. The International Registry on Hand and Composite Tissue Transplantation. Transplantation 2010; 90: 1590-4
- 13 Murphy BD, Zuker RM, Borschel GH. Vascularized composite allotransplantation: An update on medical and surgical progress and remaining challenges. J Plast Reconstr Aesthet Surg 2013; 66: 1449-55
- 14 Jones JW, Gruber SA, Barker JH, Breidenbach WC. Successful hand transplantation. One-year follow-up. Louisville Hand Transplant Team. N Engl J Med 2000; 343: 468-73
- 15 Kuiken TA, Li G, Lock BA, Lipschutz RD, Miller LA, Stubblefield KA. et al. Targeted muscle reinnervation for real-time myoelectric control of multifunction artificial arms. JAMA 2009; 301: 619-28
- 16 Harvey ZT, Loomis GA, Mitsch S, Murphy IC, Griffin SC, Potter BK. et al. Advanced rehabilitation techniques for the multi-limb amputee. J Surg Orthop Adv 2012; 21: 50-7
- 17 Wright TW, Hagen AD, Wood MB. Prosthetic usage in major upper extremity amputations. J Hand Surg Am 1995; 20: 619-22
- 18 McFarland LV, Hubbard Winkler SL, Heinemann AW, Jones M, Esquenazi A. Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts. J Rehabil Res Dev 2010; 47: 299-316
- 19 Tintle SM, Potter BK. Hand transplantation. JBJS Rev 2014; 2: 1-9
- 20 Ashvetiya T, Mundinger GS, Kukuruga D, Bojovic B, Christy MR, Dorafshar AH. et al. Donor-recipient human leukocyte antigen matching practices in vascularized composite tissue allotransplantation: A survey of major transplantation centers. Plast Reconstr Surg 2014; 134: 121-9
- 21 Paramesh AS, Sullivan K, Heneghan J, Zhang R, Ranum K, Haydel T. et al. A direct comparison of donor peripheral blood vs. lymph nodes as a source of crossmatching material for kidney transplantation, abstract publication, Am J Transplant 2012; 12: 337
- 22 Brandacher G, Ninkovic M, Piza-Katzer H, Gabl M, Hussl H, Rieger M. et al. The Innsbruck hand transplant program: Update at 8 years after the first transplant. Transplant Proc 2009; 41: 491-4
- 23 Hautz T, Brandacher G, Zelger B, Gorantla VS, Lee AW, Pratschke J. et al. Immunologic aspects and rejection in solid organ versus reconstructive transplantation. Transplant Proc 2010; 42: 3347-53
- 24 Petruzzo P, Dubernard JM. The International Registry on Hand and Composite Tissue allotransplantation. Clin Transpl 2011; 247-53
- 25 Shores JT, Brandacher G, Lee WP. Hand and upper extremity transplantation: An update of outcomes in the worldwide experience. Plast Reconstr Surg 2015; 135: 351e-60e
- 26 Dubernard JM, Lengelé B, Morelon E, Testelin S, Badet L, Moure C. et al. Outcomes 18 months after the first human partial face transplantation. N Engl J Med 2007; 357: 2451-60
- 27 Barret JP, Gavaldà J, Bueno J, Nuvials X, Pont T, Masnou N. et al. Full face transplant: The first case report. Ann Surg 2011; 254: 252-6
- 28 Smeets R, Rendenbach C, Birkelbach M, Al-Dam A, Gröbe A, Hanken H. et al. Face transplantation: On the verge of becoming clinical routine?. Biomed Res Int 2014; 2014: 907272
- 29 Fischer S, Kueckelhaus M, Pauzenberger R, Bueno EM, Pomahac B. Functional outcomes of face transplantation. Am J Transplant 2015; 15: 220-33