Hand and composite tissue allotransplantation (CTA) holds great potential for reconstructive surgery but its development currently is limited by the side effects of the immunosuppresive drugs. Induction of specific tolerance, a situation in which the recipient does not mount an immune response against the allograft but remains fully immunocompetent, holds exciting promise. The generation of mixed hematopoietic chimerism by infusing the recipient with donor bone marrow cells has been shown to induce tolerance without chronic immunosuppression. Genetic matching of the donor and the recipient is another option for transplanting composite tissues with only an initial course of immunosuppression. Experiments showed long term survival of musculoskeletal allografts between major histocompatibility complex (MHC)-matched miniature swine. Finally, new immunosuppressive agents with a more targeted action will reduce side effects and may prevent the development of chronic rejection. Skin-specific immunosuppression is particularly useful for limb transplants because skin, regarded as the most antigenic component, is easily accessible to topical or irradiation therapies.
|Original language||English (US)|
|Number of pages||5|
|Journal||Journal of the American Society for Surgery of the Hand|
|State||Published - Aug 2003|
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