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The Advent of Vascularized Composite Allotransplantation. 2017

Curtis L Cetrulo, and Zhi Yang Ng, and Jonathan M Winograd, and Kyle R Eberlin
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 15 Parkman Street, Wang ACC #435, Boston, MA 02114, USA; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Charlestown Navy Yard, Building 149, 13th Street, Suite 9019, Boston, MA 02129, USA. Electronic address: CCETRULO@mgh.harvard.edu.

Modern microsurgical techniques have made possible a broad spectrum of novel means for the reconstruction of complex bone and soft tissue defects. These techniques, in combination with developments in transplant immunology, have led to successful hand and facial allotransplantation and achievement of the highest rung in the reconstructive ladder - truly replacing like with like. The utilization of contemporary microsurgical technique in the context of vascularized composite allotransplantation (VCA) (1) permits successful technical execution and feasibility of VCA, (2) facilitates the study of immunologic tolerance in VCA preclinical models, and (3) optimizes functional VCA outcomes.

UI MeSH Term Description Entries
D007108 Immune Tolerance The specific failure of a normally responsive individual to make an immune response to a known antigen. It results from previous contact with the antigen by an immunologically immature individual (fetus or neonate) or by an adult exposed to extreme high-dose or low-dose antigen, or by exposure to radiation, antimetabolites, antilymphocytic serum, etc. Immunosuppression (Physiology),Immunosuppressions (Physiology),Tolerance, Immune
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D006084 Graft Rejection An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D063986 Vascularized Composite Allotransplantation Transference of multiple tissues, such as muscle, bone, nerve, and skin, as a functional unit for reconstructive purposes. Blood supply to the transplanted tissues is maintained throughout the transplantation procedure with minimal ischemia. Maintenance of vascularity in the graft promotes its viability, function, and survival in the recipient. Composite Tissue Allogeneic Transplantation,Composite Tissue Allografting,Composite Tissue Allotransplantation,Vascularized Composite Allografting,Allografting, Composite Tissue,Allografting, Vascularized Composite,Allotransplantation, Composite Tissue,Allotransplantation, Vascularized Composite
D064595 Composite Tissue Allografts A graft consisting of multiple tissues, such as muscle, bone, nerve, vasculature, and skin, comprising a functional unit for reconstructive purposes. Vascularized Composite Allografts,Composite Tissue Allograft,Vascularized Composite Allograft

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