Grasping time - longevity of vascularized composite allografts.

IF 1.8 4区医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2024-12-01 Epub Date: 2024-10-23 DOI:10.1097/MOT.0000000000001177

Franka Messner, Claudia Sardu, Palmina Petruzzo

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Abstract

Purpose of review: Despite significant advancements in the field of vascularized composite allotransplantation, challenges, particularly regarding the long-term viability and functionality of vascularized composite allotransplantation (VCA) grafts, persist. This paper provides a review of the current literature on the longevity of VCA grafts, focusing on factors influencing graft survival, immunological considerations and clinical outcomes.

Recent findings: Longevity of VCA grafts is influenced by a variety of peri- and postoperative factors including cold ischemia time, human leukocyte antigen matching, environmental exposure, psychosocial factors, adherence, immunosuppression, and complications. Due to the limited number of VCA transplants performed and heterogenous reporting, direct correlation of single factors with VCA outcomes remains inconclusive. Indirect evidence, however, supports their importance. High immunosuppressive burden, frequent occurrence of acute and accumulating cases of chronic rejection remain a significant challenge of the field.

Summary: Insights gained from this review aim to inform clinical practice and guide future research endeavors with the goal of ameliorating outcomes after VCA transplantation and facilitate wider use of VCA grafts for restoration of tissue defects.

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抓取时间--血管化复合异体移植物的寿命。

综述的目的：尽管血管化复合异体移植领域取得了重大进展，但挑战依然存在，尤其是血管化复合异体移植（VCA）移植物的长期存活率和功能。本文综述了目前有关血管化复合异体移植移植物寿命的文献，重点关注影响移植物存活的因素、免疫学考虑因素和临床结果：VCA移植物的寿命受多种围手术期和术后因素的影响，包括冷缺血时间、人类白细胞抗原匹配、环境暴露、社会心理因素、依从性、免疫抑制和并发症。由于进行的 VCA 移植数量有限，且报告内容不一，单一因素与 VCA 结果的直接相关性仍无定论。不过，间接证据证明了这些因素的重要性。高免疫抑制负担、频繁发生的急性和累积性慢性排斥反应病例仍是该领域面临的重大挑战。总结：本综述旨在为临床实践提供参考，并指导未来的研究工作，以改善 VCA 移植后的预后，促进 VCA 移植物在修复组织缺损方面的广泛应用。

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来源期刊

Current Opinion in Organ Transplantation 医学-移植

CiteScore

4.10

自引率

4.50%

发文量

124

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.

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