Vascular Composite Allografts (VCA): New Transplants, New Infections

Abstract

Vascularized composite allografts, or VCA transplants, are allotransplants that incorporate multiple tissues transplanted as a single functional unit, most commonly hands or face. They are, by definition, transplants aimed at improving quality of life rather than life sparing. Yet they may also be life-giving in the case of temporary uterine transplants, where the goal is to carry a healthy pregnancy through to term and delivery. Because of the multiple tissue layers involved and the systemic immunosuppression required to prevent rejection, VCA transplants carry unique infection risks, distinct for each tissue in VCA. By understanding the different infectious risks carried by different tissues, this chapter builds a framework to understand and evaluate infection of any vascularized composite allograft.