Molly Howsare1, Christopher M Jones, Allan M Ramirez. 1. aDepartment of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine bDepartment of Surgery, Division of Hepatobiliary Surgery and Transplantation, University of Louisville cTrager Transplant Center, Jewish Hospital, Louisville, Kentucky, USA.
Abstract
PURPOSE OF REVIEW: Over the last two decades advances in vascularized composite allotransplantation have achieved clinically significant milestones. This review provides a synopsis for immunosuppressive maintenance therapy for VCA and discusses the nuances surrounding the determination of the right amount of immunosuppression in vascularized composite allotransplantation. RECENT FINDINGS: Functional results after vascularized composite allotransplantation remain highly encouraging as are the immunologic outcomes, however, challenges persist. Currently, although conventional immunosuppressive protocols have been successful at preventing allograft loss; they have not totally prevented episodes of acute rejection in the skin. Furthermore, vascularized composite allotransplantation carries a significant risk profile attributed to the complications of life-long, high-dose immunosuppression regimens. SUMMARY: Examining conventional treatment protocols can lead to the development of novel immunosuppression concepts that will ultimately assist in favorably tilting the risk-benefit scale for these life-changing transplants.
PURPOSE OF REVIEW: Over the last two decades advances in vascularized composite allotransplantation have achieved clinically significant milestones. This review provides a synopsis for immunosuppressive maintenance therapy for VCA and discusses the nuances surrounding the determination of the right amount of immunosuppression in vascularized composite allotransplantation. RECENT FINDINGS: Functional results after vascularized composite allotransplantation remain highly encouraging as are the immunologic outcomes, however, challenges persist. Currently, although conventional immunosuppressive protocols have been successful at preventing allograft loss; they have not totally prevented episodes of acute rejection in the skin. Furthermore, vascularized composite allotransplantation carries a significant risk profile attributed to the complications of life-long, high-dose immunosuppression regimens. SUMMARY: Examining conventional treatment protocols can lead to the development of novel immunosuppression concepts that will ultimately assist in favorably tilting the risk-benefit scale for these life-changing transplants.
Authors: Raman Venkataramanan; Alexander M Spiess; Firuz G Feturi; Jignesh V Unadkat; Wensheng Zhang; Mohamed El Hag; Yong Wang; Chiaki Komatsu; Damian Grybowski; Zhaoxiang Zhang; Vasil Erbas; Huseyin Sahin; Sean Mcclaine; Sinan Oksuz; Jan Plock; Vijay S Gorantla; Kia M Washington; Mario G Solari Journal: Pharm Res Date: 2022-08-02 Impact factor: 4.580
Authors: C Anton Fries; Shari D Lawson; Lin C Wang; Kai V Slaughter; Praveen K Vemula; Ashish Dhayani; Nitin Joshi; Jeffrey M Karp; Rory F Rickard; Vijay S Gorantla; Michael R Davis Journal: PLoS One Date: 2019-01-24 Impact factor: 3.240
Authors: Minhyung Kim; Daniel T Fisher; Paul N Bogner; Umesh Sharma; Han Yu; Joseph J Skitzki; Elizabeth A Repasky Journal: Clin Transl Med Date: 2022-08