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Immunosuppression in Composite Tissue Allotransplantation

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Abstract

Composite tissue allotransplantation (CTA) is emerging as a new modality in reconstructive surgery as potential treatment for complex tissue, anatomic and functional defects. While the technical aspects of such procedures are constantly undergoing refinement, the practical issues due to the need and as a result, lifelong risks of exposure to the immunosuppressive drugs, remains as a major drawback. The implementation of induction and maintenance therapy protocols used in solid organ transplantation (SOT) has resulted in excellent patient and graft survival in CTA and has minimized the risk of graft loss due to uncontrolled rejection. Further understanding of the mechanisms and tempo of graft acceptance and rejection in CTA may lead to protocols that minimize the need for maintenance immunosuppressive therapy and as a result reduce the risk for long-term side effects.

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Abbreviations

AZA:

Azathioprine

ATG:

Antithymocyte globulin

CNI:

Calcineurin inhibitors

CTA:

Composite tissue allotransplantation

CsA:

Cyclosporine

HSC:

Hematopoietic stem cell

IL:

Interleukin

MMF:

Mycophenolate mofetil

MPA:

Mycophenolic acid

RAPA:

Rapamune

SOT:

Solid organ transplantation

Tac:

Tacrolimus

TDM:

Therapeutic drug monitoring

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Author information

Authors and Affiliations

  1. Department of HPB/Liver Transplant Surgery, Cleveland Clinic, Cleveland, OH, USA

    Bijan Eghtesad

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  1. Bijan Eghtesad
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  2. John J. Fung
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Correspondence to Bijan Eghtesad .

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Editors and Affiliations

  1. Dept. Plastic Surgery A/60, Cleveland Clinic Foundation, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Maria Z. Siemionow

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Eghtesad, B., Fung, J.J. (2011). Immunosuppression in Composite Tissue Allotransplantation. In: Siemionow, M. (eds) The Know-How of Face Transplantation. Springer, London. https://doi.org/10.1007/978-0-85729-253-7_41

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  • DOI: https://doi.org/10.1007/978-0-85729-253-7_41

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