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.

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