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Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages

As clinical experience with surgical techniques and immunosuppression in vascularized composite allotransplantation recipients has accumulated, vascularized composite allotransplantation for hand and face have become standard of care in some countries for select patients who have experienced catastr...

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Autores principales: Fleissig, Yoram Y, Beare, Jason E, LeBlanc, Amanda J, Kaufman, Christina L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607771/
https://www.ncbi.nlm.nih.gov/pubmed/33194200
http://dx.doi.org/10.1177/2050312120968721
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author Fleissig, Yoram Y
Beare, Jason E
LeBlanc, Amanda J
Kaufman, Christina L
author_facet Fleissig, Yoram Y
Beare, Jason E
LeBlanc, Amanda J
Kaufman, Christina L
author_sort Fleissig, Yoram Y
collection PubMed
description As clinical experience with surgical techniques and immunosuppression in vascularized composite allotransplantation recipients has accumulated, vascularized composite allotransplantation for hand and face have become standard of care in some countries for select patients who have experienced catastrophic tissue loss. Experience to date suggests that clinical vascularized composite allotransplantation grafts undergo the same processes of allograft rejection as solid organ grafts. Nonetheless, there are some distinct differences, especially with respect to the immunologic influence of the skin and how the graft is affected by environmental and traumatic insults. Understanding the mechanisms around these similarities and differences has the potential to not only improve vascularized composite allotransplantation outcomes but also outcomes for all types of transplants and to contribute to our understanding of how complex systems of immunity and function work together. A distinct disadvantage in the study of upper extremity vascularized composite allotransplantation recipients is the low number of clinical transplants performed each year. As upper extremity transplantation is a quality of life rather than a lifesaving transplant, these numbers are not likely to increase significantly until the risks of systemic immunosuppression can be reduced. As such, experimental models of vascularized composite allotransplantation are essential to test hypotheses regarding unique characteristics of graft rejection and acceptance of vascularized composite allotransplantation allografts. Rat hind limb vascularized composite allotransplantation models have been widely used to address these questions and provide essential proof-of-concept findings which can then be extended to other experimental models, including mice and large animal models, as new concepts are translated to the clinic. Here, we review the large body of rat hind limb vascularized composite allotransplantation models in the literature, with a focus on the various surgical models that have been developed, contrasting the characteristics of the specific model and how they have been applied. We hope that this review will assist other researchers in choosing the most appropriate rat hind limb transplantation model for their scientific interests.
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spelling pubmed-76077712020-11-13 Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages Fleissig, Yoram Y Beare, Jason E LeBlanc, Amanda J Kaufman, Christina L SAGE Open Med Article As clinical experience with surgical techniques and immunosuppression in vascularized composite allotransplantation recipients has accumulated, vascularized composite allotransplantation for hand and face have become standard of care in some countries for select patients who have experienced catastrophic tissue loss. Experience to date suggests that clinical vascularized composite allotransplantation grafts undergo the same processes of allograft rejection as solid organ grafts. Nonetheless, there are some distinct differences, especially with respect to the immunologic influence of the skin and how the graft is affected by environmental and traumatic insults. Understanding the mechanisms around these similarities and differences has the potential to not only improve vascularized composite allotransplantation outcomes but also outcomes for all types of transplants and to contribute to our understanding of how complex systems of immunity and function work together. A distinct disadvantage in the study of upper extremity vascularized composite allotransplantation recipients is the low number of clinical transplants performed each year. As upper extremity transplantation is a quality of life rather than a lifesaving transplant, these numbers are not likely to increase significantly until the risks of systemic immunosuppression can be reduced. As such, experimental models of vascularized composite allotransplantation are essential to test hypotheses regarding unique characteristics of graft rejection and acceptance of vascularized composite allotransplantation allografts. Rat hind limb vascularized composite allotransplantation models have been widely used to address these questions and provide essential proof-of-concept findings which can then be extended to other experimental models, including mice and large animal models, as new concepts are translated to the clinic. Here, we review the large body of rat hind limb vascularized composite allotransplantation models in the literature, with a focus on the various surgical models that have been developed, contrasting the characteristics of the specific model and how they have been applied. We hope that this review will assist other researchers in choosing the most appropriate rat hind limb transplantation model for their scientific interests. SAGE Publications 2020-10-30 /pmc/articles/PMC7607771/ /pubmed/33194200 http://dx.doi.org/10.1177/2050312120968721 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Fleissig, Yoram Y
Beare, Jason E
LeBlanc, Amanda J
Kaufman, Christina L
Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages
title Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages
title_full Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages
title_fullStr Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages
title_full_unstemmed Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages
title_short Evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: Approaches and advantages
title_sort evolution of the rat hind limb transplant as an experimental model of vascularized composite allotransplantation: approaches and advantages
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607771/
https://www.ncbi.nlm.nih.gov/pubmed/33194200
http://dx.doi.org/10.1177/2050312120968721
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