Composite Tissue Allotransplantation: Past, Present and Future-The History and Expanding Applications of CTA as a New Frontier in Transplantation

Institute for Cellular Therapeutics, University of Louisville, Louisville, Kentucky, USA.
Transplantation Proceedings (Impact Factor: 0.98). 04/2009; 41(2):463-5. DOI: 10.1016/j.transproceed.2009.01.027
Source: PubMed


Composite tissue allotransplantation (CTA) transplantation is currently being performed with increasing frequency in the clinic. The feasibility of the procedure has been confirmed in over 40 successful hand transplants, 3 facial reconstructions, and vascularized knee, esophageal, abdominal wall, and tracheal allografts. The toxicity of chronic, nonspecific immunosuppression remains a major limitation to the widespread availability of CTA and is associated with opportunistic infections, nephrotoxicity, end-organ damage, and an increased rate of malignancy. Methods to reduce or eliminate the requirement for immunosuppression would represent a significant step forward in the field. Mixed chimerism induces tolerance to solid organ and tissue allografts, including CTA. This overview focuses on the history and expanding applications of CTA as a new frontier in transplantation, and considers the important hurdles that must be overcome through research to allow widespread clinical application.

17 Reads
  • Source
    • "Skin is the largest component of FT, and it is well known to have high immunogenic property. For that reason, after a FT, it is inevitable that episodes of acute and chronic rejection occur (2,7). Nowadays and, in order to prevent FT rejection, non-specific induction of overall immunosuppression is used as a triple therapy based on postoperative administration of mycophenolate mofetil, tacrolimus and steroids. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: Update on clinical results obtained by the first worldwide facial transplantation teams as well as review of the literature concerning the main surgical, immunological, ethical, and follow-up aspects described on facial transplanted patients. Study design: MEDLINE search of articles published on “face transplantation” until March 2012. Results: Eighteen clinical cases were studied. The mean patient age was 37.5 years, with a higher prevalence of men. Main surgical indication was gunshot injuries (6 patients). All patients had previously undergone multiple conventional surgical reconstructive procedures which had failed. Altogether 8 transplant teams belonging to 4 countries participated. Thirteen partial face transplantations and 5 full face transplantations have been performed. Allografts are varied according to face anatomical components and the amount of skin, muscle, bone, and other tissues included, though all were grafted successfully and remained viable without significant postoperative surgical complications. The patient with the longest follow-up was 5 years. Two patients died 2 and 27 months after transplantation. Conclusions: Clinical experience has demonstrated the feasibility of facial transplantation as a valuable reconstructive option, but it still remains considered as an experimental procedure with unresolved issues to settle down. Results show that from a clinical, technical, and immunological standpoint, facial transplantation has achieved functional, aesthetic, and social rehabilitation in severely facial disfigured patients. Key words:Face transplantation, composite tissue transplantation, face allograft, facial reconstruction, outcomes and complications of face transplantation.
    Medicina oral, patologia oral y cirugia bucal 12/2012; 18(2). DOI:10.4317/medoral.18552 · 1.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Surgical correction of congenital and acquired facial deformities has transcended the primitive era of using non biologic materials to current attempts at own face growing through biotechnology. A summative account of this trend is still lacking in the literature. The objective of this article is to present an update on current knowledge in the strides to achieve functionally and aesthetically perfect facial reconstruction. It highlights the impact of advancements in 3D imaging, stereolithographic biomodelling, microvascular surgical tissue transplantation and tissue biotechnology in the surgical efforts to solve the problems of facial disfigurement whether congenital or acquired.
    Journal of Maxillofacial and Oral Surgery 12/2012; 11(4). DOI:10.1007/s12663-012-0363-9
  • [Show abstract] [Hide abstract]
    ABSTRACT: In this paper we present a hierarchical symbolic layout system. This system combines a procedural layout language with a symbolic layout editor, on-line incremental netlist extraction with connectivity checking, compaction and wire length minimization. The compactor features overlapping cells, wire segments that cross cell boundaries and connecting inside cells, and sliding contacts. A new model for wire length minimization is proposed.
    Design Automation, 1985. 22nd Conference on; 07/1985
Show more


17 Reads
Available from