The Role of Ischemia-Reperfusion Injury in Reconstructive Transplantation

Reconstructive transplantation, also referred to as vascularized composite allotransplantation (VCA), has rapidly emerged as a viable approach to repairing complex tissue defects. Over the past 20 years, major advances have been made in the field of VCA allowing for successful transplantation of over 150 hand/forearm/arm, larynx, trachea, abdominal wall, vascularized knee, and facial transplants with encouraging outcomes. These innovations have currently outpaced the scientific community’s ability to fully address certain immunological and clinical challenges. The literature on ischemia-reperfusion injury (IRI) in VCA is limited and mechanistic questions remain. Specifically, the role IRI may play in acute rejection, the progression towards chronic rejection, or immune regulation and tolerance induction has only been partially or indirectly addressed. Hence, much of what we understand regarding IRI in VCA is extrapolated from research in solid organ transplantation (SOT). This review will address the role of IRI in VCA, first outlining its impact on SOT, it’s effects on the immune system and allograft rejection, as well as the clinical implications that IRI has for VCA outcomes. *Corresponding author: Gerald Brandacher, Scientific Director, Reconstructive Transplantation Program, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Ross Research Building 749D, 720 Rutland Avenue, Baltimore, MD21205,USA.Tel: (443) 287-6679; Fax: (410) 614-1296; E-mail: [email protected] Received May 03, 2013; Accepted June 07, 2013; Published June 10, 2013 Citation: Khalifian S, Cooney DS, Andrew Lee WP, Brandacher G (2013) The Role of Ischemia-Reperfusion Injury in Reconstructive Transplantation. J Transplant Technol Res S3: 004. doi:10.4172/2161-0991.S3-004 Copyright: © 2013 Khalifian S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.