Skin allograft and vascularized composite allograft: Potential for long-term efficacy in the context of lymphatic modulation

Jacob Rinkinen, Ryan Selley, Shailesh Agarwal, Shawn Loder, Benjamin Levi

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Tissue transplantation restores form and function in burn patients. The treatment of burn injuries is influenced by severity, location, and the percentage of total body surface area. There have been a number of different techniques developed to temporize and repair the destroyed tissue. However, in patients with large wound burden, sufficient donor site tissue may not be available for autograft harvesting. Such extensive burns necessitate other temporary and permanent options for wound coverage such as skin or vascularized composite allografts (VCA). Rejection of these tissues presents an ongoing problem which is currently managed using a host of systemic immunosuppressive medications. This article discusses the mechanism behind the innate and adaptive immune systems rejection of the allografts. By understanding these pathways, various techniques using immunomodulatory protocols have led to increased allograft survival. However, our primary interest lies in the initial recognition of the graft. We tailor this article to have a specific emphasis on lymphatic modulation as a potential adjunctive therapy. Reviews of the studies evaluating the effect of lymph node modulation on graft survival are described with future implications to allograft transplant research.

Original languageEnglish (US)
Pages (from-to)355-361
Number of pages7
JournalJournal of Burn Care and Research
Volume35
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

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