Immunological Monitoring

  • Medhat Askar


Facial transplants involve vascularized allografts which are prone to various types of antibody- and cell-mediated rejection. The requirement for multiple non-immunological layers of donor suitability in this context dictates careful assessment of which immunological criteria to consider. Although the clinical practice of facial transplants is fairly recent, experience from other organ and tissue transplants has shown that pre-transplant immunological risk assessment and post-transplant monitoring are critical to maximize graft survival. The real challenge is to correlate short- and long-term outcomes of this procedure with individual tests to determine their clinical relevance in this unique setting. An overview of the landscape of modern immunological testing methods will be presented with emphasis on the clinical applicability of these methods. Both routine and novel testing methods will be reviewed. Relevant studies to assess the clinical significance of different methods in other solid organ and hematopoietic stem cell transplants in humans and from animal models of composite tissue allografts (CTA) will be highlighted.


Peripherally Insert Central Catheter Hyperacute Rejection Panel Reactive Antibody Face Transplant Kidney Allograft Rejection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



antibody-mediated rejection


adenosine tri-phosphate


cytotoxic crossmatch


composite tissue allotransplantation


donor-specific HLA antibodies


enzyme-linked Immunosorbent Assay


enzyme-linked immunospot


flow cytometric crossmatch


graft-versus-host disease


human leukocyte antigen


human progenitor cells


major histocompatibility complex class I related chain A


not published


peripheral blood lymphocytes


polymerase chain reactions




peripherally inserted central catheter


panel reactive antibodies


sequence-specific oligonucleotide probes


sequence-specific primer


tumor necrosis factor



I would like to thank Drs. Robin Avery, Bijan Eghtesad, Titte Srinivas, and Maria Siemionow from the Cleveland Clinic Transplant Center, Drs. Howard Gebel and Robert Bray from the Department of Pathology at Emory University, and Garnett Smith from the Cleveland Clinic Lerner College of Medicine for providing clinical follow-up data and insightful discussion.


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Copyright information

© Springer London 2011

Authors and Affiliations

  1. 1.Allogen Laboratories, Transplant Center, Department of Surgery, Cleveland Clinic, Cleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandUSA

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