Eponychial lesions following bilateral upper extremity vascular composite allotransplantation: a case report

Fallahian, Fedra; Molway, David; Jadeja, Saagar; Clark, Rachael A.; Marty, Francisco M.; Riella, Leonardo V.; Chandraker, Anil; Talbot, Simon G.

doi:10.1080/23320885.2018.1431047

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…In a series of 12 UEA cases from China, most patients reportedly developed ‘uneven nails’, with no further precision as to the timing and the aspect of nail changes [18]. In one patient, redness of the eponychium revealed an underlying HPV + wart [19].…”

Section: Discussionmentioning

confidence: 99%

Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection – a retrospective study

et al. 2020

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Upper extremity allotransplantation (UEA) is the more common type of vascularized composite allotransplantation of which more than 80 patients have benefited worldwide. These allografts includealong with the skinthe nail unit, a specialized epithelial appendage which may be the target of graft rejection. We report an UEA recipient who developed, as an initial manifestation of graft rejection, onychomadesis, that is shedding of the nail plate starting from the proximal nail bed. On this occasion, we reviewed the nail changes we have observed in a series of eight patients with UEA who were grafted and followed in our hospital since 1998 (mean follow-up period of 9.75 years). We also reviewed the relevant literature reporting nail changes in UEA recipients. A brief discussion on the significance of these changes in the context of UEA is provided with emphasis on onychomadesis, a finding usually related to graft rejection in this specific setting.

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Section: Discussionmentioning

confidence: 99%

Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection – a retrospective study

et al. 2020

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Immunosuppressive strategies in face and hand transplantation: a comprehensive systematic review of current therapy regimens and outcomes

Huelsboemer,

Boroumand,

Kochen

et al. 2024

Front. Transplant.

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BackgroundRecipients of Vascularized Composite Allotransplants require effective immunosuppressive therapy to prevent graft rejection. This systematic review summarizes the current body of literature on immunosuppressive regimens used in face and hand transplants while summarizing their outcome in terms of rejection, renal failure, and infections.MethodsA systematic search of electronic databases was conducted to identify relevant studies from 1998 until July 1st, 2023. We included all studies that discussed immunosuppressive strategies in face and hand transplant recipients according to PRISMA.ResultsThe standard triple maintenance therapy was mostly adjusted due to nephrotoxicity or high incidence of rejection. The most common alternative treatments utilized were sirolimus (25/91; 27.5%) or everolimus (9/91; 9.9%) following hand- and photophoresis (7/45; 15.6%), sirolimus (5/45; 11.1%) or belatacept (1/45; 2.2%) following face transplantation. Episodes of rejection were reported in 60 (65.9%) of hand- and 33 (73%) of face transplant patients respectively. Graft loss of 12 (13.2%) hand and 4 (8.9%) face transplants was reported. Clinical CMV infection was observed in 6 (6.6%) hand and 7 (15.5%) face transplant recipients.ConclusionsBased on the herein presented data, facial grafts exhibited a heightened incidence of rejection episodes and CMV infections. Facial mucosa adds complexity to the immunological graft composition highlighting the need of individualized immunosuppressive regimens and further research.

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Eponychial lesions following bilateral upper extremity vascular composite allotransplantation: a case report

Cited by 2 publications

References 12 publications

Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection – a retrospective study

Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection – a retrospective study

Immunosuppressive strategies in face and hand transplantation: a comprehensive systematic review of current therapy regimens and outcomes

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