Mechanisms of rejection in vascular composite allotransplantation

Research output: Contribution to journalReview articlepeer-review


Purpose of review For patients with devastating injuries in whom standard reconstruction is not an option, vascularized composite allotransplantation (VCA) has become a viable means of restoring form and function. However, immunological rejection continues to be a problem in VCA and has not yet been fully characterized. As the field is relatively new, much of the data on rejection and immunosuppression have been extrapolated from that of solid organ transplantation. In this review, we cover the basic mechanisms of rejection as they relate specifically to VCA with analysis of recent literature and future directions. Recent findings Recent clinical studies have supported previously postulated T-cell-mediated mechanism of acute rejection and have also made strides in differentiating rejection from inflammation from other skin conditions and with different treatment regimens. Antibody-mediated rejection has been described in recent cases as well as treatment of presensitized patients receiving VCAs. With more long-term grafts, chronic changes, including vasculopathy, are being reported. Summary Clinically observed types of rejection in VCA include mainly cell-mediated, antibody-mediated and chronic rejection. Advances in diagnosis and treatment of rejection have been made, but there is still much to be learned about VCA-specific rejection.

Original languageEnglish (US)
Pages (from-to)28-33
Number of pages6
JournalCurrent opinion in organ transplantation
Issue number1
StatePublished - Feb 1 2018


  • antibody-mediated rejection
  • cell-mediated rejection
  • vascularized composite allotransplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation


Dive into the research topics of 'Mechanisms of rejection in vascular composite allotransplantation'. Together they form a unique fingerprint.

Cite this