Mixed allogeneic chimerism and tolerance to composite tissue allografts

Prabhune, Kaustubha A.; Gorantla, Vijay S.; Maldonado, Claudio; Perez-Abadia, Gustavo; Barker, John H.; Ildstad, Suzanne T.

doi:10.1002/1098-2752(2000)20:8<441::aid-micr16>3.0.co;2-a

Cited by 55 publications

(38 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of mixed allogeneic chimerism in tolerance induction in CTA [55] was presented by Christina Kaufmann. When donor bone marrow containing stem cells is transplanted in a treated recipient, the newly developing recipient T-cells begin to see donor cells as "self".…”

Section: Current Status Of Ctamentioning

confidence: 99%

Composite Tissue Allotransplantation (CTA): Current Status and Future Insights

et al. 2001

Self Cite

View full text Add to dashboard Cite

Approximately 7 million individuals (over 1 million amputees) require complex reconstructive procedures in the United States each year. The recent success of clinical composite tissue allotransplantation, attests to the fact that composite tissue allografts have tremendous potential in these life-enhancing reconstructions.This review summarizes the initial outcomes of the first four human hand transplants, together with those of the first larynx, bone, knee, nerve and tendon transplants, with special emphasis on the operative technique, graft survival and functional outcomes. The May 2000 Louisville symposium, where these results were presented was undoubtedly a milestone in the history of modern composite tissue allotransplantation. It set the stage for reconstructive and transplant surgeons, researchers, physiotherapists, patients and patient advocates and members of the community to convene and discuss major advances in current composite tissue allotransplantation. The symposium underscored the vital importance of objective evaluation of the status of composite tissue allotransplantation by frank dissemination of details of clinical results and complications of the transplants performed thus far.The composite tissue allotransplantation area is among the newest of transplant areas. The immunology of composite tissue allografts is complex, making tolerance more difficult to achieve than organ tolerance. It needs to be emphasized that any episodes of acute rejection should be prevented for perfect restoration of function and to minimize the risk of chronic rejection in composite tissue allografts. Efficacious, safe and ethical clinical tolerance protocols could improve patient acceptance of composite tissue allografts by providing an alternative to chronic immunosuppression.

show abstract

Section: Current Status Of Ctamentioning

confidence: 99%

Composite Tissue Allotransplantation (CTA): Current Status and Future Insights

et al. 2001

Self Cite

View full text Add to dashboard Cite

show abstract

“…In particular for hand transplantation, representing a non-life-saving procedure, non-myeloablative regimens are critical since intensive cytotoxic myeloablative protocols bearing the risk of significant morbidity and mortality are contraindicated. BM-based therapeutic principles have consistently shown a beneficial effect of supportive cellular therapy on organ as well as VCA survival [52][53][54]. Underlying mechanisms include, for example, effects such as macro-and micro-chimerism, and exhaustion and deletion of the recipient's alloreactive T-cell clones.…”

Section: Minimizing Immunosuppression In Hand Transplantationmentioning

confidence: 99%

Minimizing immunosuppression in hand transplantation

Brandacher

Lee

Schneeberger

2012

Expert Review of Clinical Immunology

View full text Add to dashboard Cite

“…Such protocols have shown encouraging results in solid organ transplants as well as VCA [20,21,22 • ] through mechanisms such as the establishment of macro-and micro-chimerism, and exhaustion and deletion of the donor-specific alloreactive T cell clones. Although myeloablative protocols provide sufficient immunosuppression to prevent VCA rejection and allow for engraftment of donor hematopoietic cells, they carry high risks and toxicities related to myloablation as the conditioning regimen [19].…”

Section: Bone Marrow-based Protocolsmentioning

confidence: 99%

Minimization of Immunosuppression and Tolerance Induction in Reconstructive Transplantation

et al. 2012

View full text Add to dashboard Cite

Vascularized composite allotransplantation (VCA) is an innovative reconstructive modality for patients sustaining complex injuries not amenable to conventional treatment. Advances in immunosuppression have made VCA a clinical reality and a valid reconstructive option for such patients. The requirement, however, for multi-drug high-dose immunosuppressive regimens with their numerous side effects has hindered widespread clinical application of VCA. There is thus a need for novel immunologic modalities to minimize or even obviate the need for immunosuppression (tolerance induction) while still preserving the allograft and preventing rejection. Recent advances in targeted immunotherapy and cell-based protocols were able to achieve tolerance in selected cases of solid organ transplantation. This paved the way for innovative immunomodulatory protocols now also applied to VCA that aim for minimal immunosuppression or for induction of donor-specific tolerance. These concepts and novel protocols will be discussed in this review.

show abstract

Mixed allogeneic chimerism and tolerance to composite tissue allografts

Cited by 55 publications

References 51 publications

Composite Tissue Allotransplantation (CTA): Current Status and Future Insights

Composite Tissue Allotransplantation (CTA): Current Status and Future Insights

Minimizing immunosuppression in hand transplantation

Minimization of Immunosuppression and Tolerance Induction in Reconstructive Transplantation

Contact Info

Product

Resources

About