Immunosuppression and monitoring of rejection in hand transplantation

Stefan Schneeberger, Saami Khalifian, Gerald Brandacher

Research output: Contribution to journalArticlepeer-review

Abstract

Advances in vascularized composite allotransplantation over the last decade have achieved significant milestones in basic science and translational research, as well as clinically with highly encouraging functional and immunologic outcomes. However, certain immunologic challenges remain. In particular, although tolerance has been induced to nearly all components of a hand allograft in experimental models, the skin component may still be subject to acute rejection episodes. Currently, conventional immunosuppressive protocols have been successful at preventing allograft loss; however, they have not prevented episodes of acute skin rejection. Furthermore, the profound side effect profile of the life-long, high-dose, multidrug immunosuppression regimen that is necessary to maintain a viable graft alters the risk to benefit ratio of this non-life-saving procedure. Therefore, there must be a concerted effort in the scientific community to develop novel protocols to either minimize immunosuppression or to induce tolerance to the allograft to promote the widespread application of this life-changing procedure.

Original languageEnglish (US)
Pages (from-to)208-214
Number of pages7
JournalTechniques in Hand and Upper Extremity Surgery
Volume17
Issue number4
DOIs
StatePublished - Dec 1 2013

Keywords

  • Hand transplant
  • Immune regulation
  • Immunomodulation
  • Immunosuppression
  • Monitoring
  • Monotherapy
  • Rejection
  • Tolerance
  • Vascularized composite allotransplantation

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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