Monitoring and long-term outcomes in vascularized composite allotransplantation

Kaufman, Christina L.; Ouseph, Rosemary; Marvin, Michael R.; Manon-Matos, Yorell; Blair, Brenda; Kutz, Joseph E.

doi:10.1097/mot.0000000000000025

Cited by 29 publications

(17 citation statements)

References 19 publications

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“…For example, it is arguable that logistical and immunologic challenges currently restrict the widespread clinical application of CTA. In addition to careful oversight and individualized screening procedures, further investigations are required for technical renovation to minimize the levels of surgery risk and to identify optimal immunomodulating protocols for specific patients as they seek improved quality of life [220,221]. Specifically, the use of bioreactors for tissue culture may extend ex vivo allograft survival times and enable allograft modulations that enhance graft function while mitigating immunogenicity following allotransplantation.…”

Section: Tissue Grafts Of Human Originmentioning

confidence: 99%

Advancing biomaterials of human origin for tissue engineering

Chen

Liu

2016

Progress in Polymer Science

959

513

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Biomaterials have played an increasingly prominent role in the success of biomedical devices and in the development of tissue engineering, which seeks to unlock the regenerative potential innate to human tissues/organs in a state of deterioration and to restore or reestablish normal bodily function. Advances in our understanding of regenerative biomaterials and their roles in new tissue formation can potentially open a new frontier in the fast-growing field of regenerative medicine. Taking inspiration from the role and multi-component construction of native extracellular matrices (ECMs) for cell accommodation, the synthetic biomaterials produced today routinely incorporate biologically active components to define an artificial in vivo milieu with complex and dynamic interactions that foster and regulate stem cells, similar to the events occurring in a natural cellular microenvironment. The range and degree of biomaterial sophistication have also dramatically increased as more knowledge has accumulated through materials science, matrix biology and tissue engineering. However, achieving clinical translation and commercial success requires regenerative biomaterials to be not only efficacious and safe but also cost-effective and convenient for use and production. Utilizing biomaterials of human origin as building blocks for therapeutic purposes has provided a facilitated approach that closely mimics the critical aspects of natural tissue with regard to its physical and chemical properties for the orchestration of wound healing and tissue regeneration. In addition to directly using tissue transfers and transplants for repair, new applications of human-derived biomaterials are now focusing on the use of naturally occurring biomacromolecules, decellularized ECM scaffolds and autologous preparations rich in growth factors/non-expanded stem cells to either target acceleration/magnification of the body's own repair capacity or use nature's paradigms to create new tissues for restoration. In particular, there is increasing interest in separating ECMs into simplified functional domains and/or biopolymeric assemblies so that these components/constituents can be discretely exploited and manipulated for the production of bioscaffolds and new biomimetic biomaterials. Here, following an overview of tissue auto-/allo-transplantation, we discuss the recent trends and advances as well as the challenges and future directions in the evolution and application of human-derived biomaterials for reconstructive surgery and tissue engineering. In particular, we focus on an exploration of the structural, mechanical, biochemical and biological information present in native human tissue for bioengineering applications and to provide inspiration for the design of future biomaterials.

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Section: Tissue Grafts Of Human Originmentioning

confidence: 99%

Advancing biomaterials of human origin for tissue engineering

Chen

Liu

2016

Progress in Polymer Science

959

513

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“…The importance of incorporating patient perspectives into discussions regarding vascularized composite allotransplantation cannot be overstated; indeed, they have already been shown to be a strong determinant of clinical outcomes in the realm of face and hand transplantation. 13,14 There is little reason to believe that lower limb transplantation is an exception.…”

Section: Discussionmentioning

confidence: 98%

Attitudes Regarding Lower Extremity Allotransplantation among Lower Extremity Amputees

Carty

Duclos

Talbot

et al. 2014

Plastic and Reconstructive Surgery

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“…10,25 Despite these incremental advances, the overwhelming majority of patients endures multiple episodes of acute rejection, a rigorous outpatient medical schedule, and numerous hospitalizations. 24 Patients are required to rigorously follow an immunosuppressive regimen of multiple drugs a day, they need to be constantly monitored and they are routinely examined (very often on a weekly basis) for the whole duration of their lives. The threat of chronic rejection is also very vivid for both patients and surgeons.…”

Section: The Experiment-therapy Dilemmamentioning

confidence: 99%

Reflections on a Decade of Face Transplantation

2017

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On November 27, 2005, Isabelle Dinoire underwent the world's first partial face transplant in Amiens (France) after a dog attack had left her face severely disfigured. The abrupt surgical leap found the medical community and society unprepared to deal with the scientific, ethical, and societal implications of a surgical procedure that was striving to transition from sci-fi novels to science. Today, 10 years and over 35 transplants later, public opinion has become accustomed to the concept of "face restoration" through transplantation. However, face transplantation is far from being a safe "routine" surgery and the science behind it is still mostly unknown. Patients and multidisciplinary teams of physicians confront daily medical challenges, life-threatening risks, and personal struggle that only in part come to light. Could (or should) this be the laborious, uncertain, and high-risk trajectory of disruptive medical innovation? Over the last decade, some medical discoveries and surgical advancements in the field have been closely accompanied by partial regulatory frameworks, intense ethical discussions, and meaningful changes in social beliefs across cultures and continents. Yet, a very long way is to come and the questions we still have today greatly outweigh the answers we can offer. Here, we take the chance of the 10-year anniversary of face transplantation to reflect on the path traveled and to look forward to the challenges lying ahead.

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Monitoring and long-term outcomes in vascularized composite allotransplantation

Cited by 29 publications

References 19 publications

Advancing biomaterials of human origin for tissue engineering

Advancing biomaterials of human origin for tissue engineering

Attitudes Regarding Lower Extremity Allotransplantation among Lower Extremity Amputees

Reflections on a Decade of Face Transplantation

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