Pathological Score for the Evaluation of Allograft Rejection Severity in Human Composite Tissue (Hand) Allotransplantation.

Clinicopathologic Monitoring of the Skin and Oral Mucosa of the First Human Face Allograft: Report on the First Eight Months

“…Biopsies were obtained whenever clinical findings suspect of rejection were present (namely on the face), but also in periods with no obvious clinical findings, since our previous data obtained on hand allografts had suggested that pathological signs of rejection can be seen in the absence of clinically visible lesions (5)(6)(7). During the first eight-month postgraft period, we obtained three biopsies from the facial allograft skin (two chin, one cheek), 11 biopsies from the sentinel skin graft, and 20 biopsies from the oral (cheek) mucosa (right and/or left) on various days postgraft ( Table 1).…”

Prolonged Cold Ischemic Time Results in Increased Acute Rejection in a Rat Allotransplantation Model

“…No change in the rejection process was observed between allografts stored for a prolonged cold storage Histologic evaluation showed that when the cold storage time was 24 h, the time interval for progression from grade 1 to grade 3 was significantly shorter than that in the allo-0 h group, and there was no significant difference in the time taken to reach grade 1 between the allo-0 h and allo-24 h groups. Lymphocyte infiltration of a transplant is a characteristic of cellular rejection [17], and each grade standard represents a distinct phase of the rejection response [18][19][20]. These data suggest that prolonged cold ischemic time accelerates the traffic of activated lymphocytes to allografts, apart from influencing the initiation of the rejection responses.…”

Standardizing skin biopsy sampling to assess rejection in vascularized composite allotransplantation

“…According to the Banff 2007 working classification of skin‐containing composite tissue allografts visible skin changes should be reported as follows: no signs, <10%, 10–50% and >50% . Most frequently, lesions are located at the dorsal and volar aspects of the forearm and wrist with the dorsum of the hand affected in some cases . This pattern has been referred to as the “classical” pattern of rejection.…”