Transplantation Proceedings
Volume 41, Issue 9 , Pages 3519-3528, November 2009

Composite Tissue Allotransplantation: Current Challenges

  • K.V. Ravindra

      Affiliations

    • Department of Surgery, University of Louisville, Louisville, Kentucky
  • ,
  • S. Wu

      Affiliations

    • Institute for Cellular Therapeutics, University of Louisville, Louisville, Kentucky
  • ,
  • M. McKinney

      Affiliations

    • Institute for Cellular Therapeutics, University of Louisville, Louisville, Kentucky
  • ,
  • H. Xu

      Affiliations

    • Institute for Cellular Therapeutics, University of Louisville, Louisville, Kentucky
  • ,
  • S.T. Ildstad

      Affiliations

    • Department of Surgery, University of Louisville, Louisville, Kentucky
    • Corresponding Author InformationAddress reprint requests to Suzanne T. Ildstad, MD, Director, Institute for Cellular Therapeutics, Jewish Hospital Distinguished Professor of Transplantation, Distinguished University Scholar, Professor of Surgery, University of Louisville, 570 South Preston Street, Suite 404, Louisville, KY 40202-1760

Abstract 

Composite tissue allotransplantation (CTA) in the clinic is taking firm root. Success at hand, face, knee, trachea, and laryngeal transplantation has led to widespread interest and increasing application. Despite this, skepticism is common, particularly in the realm of reconstructive surgeons. The risks of immunosuppression remain a barrier to the advancement of the field, as these are perceived by many to be prohibitive. Significant progress in the field require the development of newer immunosuppressive agents with less toxicity and methods to achieve donor specific tolerance. This review focuses on the current state of CTA—both in the clinic and the laboratory. A thorough understanding of the immunology of CTA will allow the widespread application of this promising field.

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 Supported in part by NIH R01 DK069766 and NIH 5RO1 HL063442; JDRF 1-2005-1037 and JDRF 1-2006-1466; The Department of the Navy, Office of Naval Research; The Department of the Army, Office of Army Research. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the Office of Army Research. This publication was made possible by Award No. W81XWH-07-1-0185 from the Office of Army Research; the National Foundation to Support Cell Transplant Research; the Commonwealth of Kentucky Research Challenge Trust Fund; the W. M. Keck Foundation; and The Jewish Hospital Foundation.

PII: S0041-1345(09)01305-0

doi:10.1016/j.transproceed.2009.08.052

Transplantation Proceedings
Volume 41, Issue 9 , Pages 3519-3528, November 2009