Abstract
Transplant vasculopathy has not been systematically investigated in composite tissue allotransplantation (CTA). The impact of multiple acute rejections (ARs) on long-term graft outcomes in reconstructive transplantation remains unknown. This study in a rat hind-limb allotransplantation model systematically analyzes vasculopathy and tissue-specific pathological changes secondary to multiple AR episodes. LEW rats were transplanted with BN rat hind limbs and treated as follows: Group 1 (Iso): isografts. Group 2 (CsA): Cyclosporine (CsA) qd; Group 3 (mult AR): CsA and dexamethasone only when AR was observed. No AR was observed in Groups 1 and 2. Multiple AR were observed in Group 3, and each episode was completely reversed (clinically) with pulsed CsA + dexamethasone treatment. Group 3 animals demonstrated significant vascular lesions along with skin and muscle atrophy, upregulation of profibrotic gene expression and fibrosis when compared to Groups 1 and 2. In addition, allograft bone was sclerotic, weak and prone to malunion and nonunion. Interestingly, vasculopathy was a late finding, whereas muscle atrophy with macrophage infiltration was seen early, after only a few AR episodes. Taken together, multiple AR episodes lead to vasculopathy and tissue-specific pathology in CTA. This is the first evidence of 'composite tissue vasculopathy and degeneration (CTVD)' in CTA.
Original language | English (US) |
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Pages (from-to) | 251-261 |
Number of pages | 11 |
Journal | American Journal of Transplantation |
Volume | 10 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2010 |
Externally published | Yes |
Keywords
- Chronic allograft dysfunction
- Chronic allograft rejection
- Chronic graft deterioration
- Chronic rejection
- Composite tissue allograft
- Composite tissue transplantation
- Face transplantation
- Graft fibrosis
- Graft vessel disease
- Hand transplant
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)