Abstract 44: Tolerance Induction with Post Transplantation High-Dose Cyclophosphamide relies on Recipient-derived Immune Regulation and Donor Bone Marrow in a Murine Model of Vascularized Composite Allotransplantation
نویسندگان
چکیده
PURPOSE: Developing novel treatment concepts to minimize/avoid immunosuppression by induction of immune tolerance represents the prime task in the field of transplantation. In the clinic to date, this was achieved in highly selected patients in clinical trials of kidney transplantation combined with concomitant stem cell or bone marrow transplantation. Vascularized composite allotransplantation (VCA) is evolving as viable treatment modality for patients suffering from functional and esthetic defects to craniofacial structures, extremities and urogenital tissues. In certain VCAs transplantation of vascularized bone marrow may be inherently part of the allograft designs (i.e. hands and faces) and thereby representing a unique opportunity in combining bone marrow and VCA.
منابع مشابه
Abstract 45: Vascularized Composite Allograft Tolerance Across A Full MHC Mismatch Is Possible With Transient High Dose Tacrolimus
PURPOSE: Developing novel treatment concepts to minimize/avoid immunosuppression by induction of immune tolerance represents the prime task in the field of transplantation. In the clinic to date, this was achieved in highly selected patients in clinical trials of kidney transplantation combined with concomitant stem cell or bone marrow transplantation. Vascularized composite allotransplantation...
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Although transplantation of Vascularized Composite Allografts (VCA) has become a clinical reality, complications resulting from long-term immunosuppression remain major barriers to broader indication. Ideally, induction of tolerance has been considered the Holy Grail in both solid organ and VCA transplantation. Recent advances in immunomodulatory medication and cell-based therapy exploiting don...
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Although vascularized composite allografts (VCAs) have been performed clinically for a variety of indications, potential complications from long-term immunosuppression and graft-versus-host disease remain important barriers to widespread applications. Recently it has been demonstrated that VCAs incorporating a vascularized long bone in a rat model provide concurrent vascularized bone marrow tra...
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MATERIALS AND METHODS: 8 cynomolgus monkeys received either an orthotopic hand (n=2) or heterotopic face VCA (n=6) from MHC-mismatched donors following induction with anti-thymocyte globulin. Postoperatively, triple immunosuppression – tacrolimus, mycophenolate mofetil, methylprednisolone – was maintained for up to 120 days before bone marrow transplantation (BMT) was performed. Protocol biopsi...
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Vascularized Composite Allotransplantation (VCA) such as hand and face transplants represent a viable treatment option for complex musculoskeletal trauma and devastating tissue loss. Despite favorable and highly encouraging early and intermediate functional outcomes, rejection of the highly immunogenic skin component of a VCA and potential adverse effects of chronic multi-drug immunosuppression...
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