Review of the Early Diagnoses and Assessment of Rejection in Vascularized Composite Allotransplantation

Starzl, Ravi; Brandacher, Gerald; Lee, W. P. Andrew; Carbonell, Jaime G.; Zhang, Wensheng; Schnider, Jonas; Gorantla, Vijay S.; Schneeberger, Stefan; Zheng, Xin Xiao

doi:10.1155/2013/402980

Cited by 37 publications

(24 citation statements)

References 70 publications

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“…However, the terms “mild” and “moderate” are not defined by an objective set of parameters. In addition, the correlation between Banff grade and treatment has not been established . Comparison between Banff VCA Grade I could be drawn to borderline histologic changes encountered in renal transplant pathology with the subsequent clinical challenge that they pose.…”

Section: Strengths and Limitations Of The 2007 Banff Vca Working Clasmentioning

confidence: 99%

Vascularized composite allotransplantation: a closer look at the banff working classification

et al. 2016

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SUMMARYThe first Banff vascularized composite allotransplantation meeting was held in 2007 to standardize criteria for the characterization and reporting of severity and types of rejection. As a result, the 2007 Banff VCA working classification for skin allograft pathology was formalized and now serves as the standard for diagnosis of VCA rejection. Similar to other working classification systems, strengths and limitations have been identified including the adequacy of the specimen, the definition of severity between grades, the reproducibility, the adequacy of the specimens, the types of rejection, and the integration of newer technologies such as molecular and genomic approaches. Although a relatively few number of cases have been performed and followed up to date, additional phenotypes such as antibodymediated rejection, fibrosis, atrophy, and vascular changes are being reported and characterized based on accumulated experience in the field of VCA and parallels with other solid organs. This study aims to consider strengths and limitations of the Banff VCA working system and highlights ongoing challenges and opportunities available related to histopathology in this emerging field of transplantation.

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Section: Strengths and Limitations Of The 2007 Banff Vca Working Clasmentioning

confidence: 99%

Vascularized composite allotransplantation: a closer look at the banff working classification

et al. 2016

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“…[1] At the same time, rapid advances in solid organ transplantation (SOT) paved the way for the current success of VCAs.…”

Section: Vascularized Composite Tissue Allotransplantation (Vca) — Rementioning

confidence: 99%

Current status of vascularized composite tissue allotransplantation

Edtinger¹,

Yang²,

Uehara³

et al. 2014

Burn Trauma

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Vascularized composite tissue allotransplantation (VCA) offers treatment options of complex functional deficiencies that cannot be repaired with conventional reconstructive methods. VCAs consist of blocks of functional units comprising different tissue types such as skin, bone, muscle, nerves, blood vessels, tendons, ligaments and others, and are thus substantially different from the composition of organ transplants. The field of VCA has made fascinating progresses in the recent past. Among other VCAs, numerous successful hand, face and limb transplants have been performed in the world. At the same time, specific questions in regard to innate and adaptive immunity, consequences of ischemia/reperfusion injury, immunosuppression, preservation, and regenerative capacity remain. In spite of this, the field is poised to make significant advances in the near future.

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“…Rejection is usually assessed by visual skin inspection and histological analysis (Hautz et al, 2013;Zor et al, 2016). Because skin tissue is the most antigenic component in a VCA, skin is considered as the sentinel target during acute rejection of a VCA (Murray, 1971;Starzl et al, 2013;Swearingen et al, 2008). However, it has been reported that the antigenicity of muscle is higher than that of skin (Lee et al, 1991), and it is unclear which tissue has the greatest antigenicity within a VCA.…”

Section: Introductionmentioning

confidence: 99%

Relative antigenicity of components in vascularized composite allotransplants: An experimental study of microRNAs expression in rat hind limb transplantation model

et al. 2018

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Background Skin is considered to be the most antigenic component of all vascularized composite allotransplantation tissues. However, no studies have used methods other than histological assessment to analyze the relative antigenicity of various components. In this study, we analyzed gene expression to investigate the relative antigenicity of each component in the transplanted limb. Methods Seven Brown Norway rats and 31 Lewis rats were assigned to two groups: an allograft group and a syngeneic (control) group. Brown Norway rats were used as the allogeneic donors, and Lewis rats were used as the syngeneic donors and recipients. About 13 recipients in the allograft group and 12 recipients in the control group were analyzed. Histological assessment was performed in 5 of the recipients in each group, and microRNA expression was analyzed in the remaining recipients, except for 1 recipient in the syngeneic group. Results In the allograft group, the relative microRNA‐146a expression was significantly higher in skin (2.34 ± 0.44) than in muscle (1.25 ± 0.22; p = .034) and bone (1; p = .0081). In the allograft group, microRNA‐155 expression was significantly higher in skin (1.91 ± 0.18) than in bone (1; p = .010). Histological assessment showed that some skin tissue in the allograft group showed evidence of severe acute rejection. Conclusions The microRNA‐146a and microRNA‐155 seemed to reflect the relative antigenicity during acute rejection of transplanted limbs. Skin seemed to be more antigenic than muscle and bone in both the histological assessment and gene expression analysis.

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Review of the Early Diagnoses and Assessment of Rejection in Vascularized Composite Allotransplantation

Cited by 37 publications

References 70 publications

Vascularized composite allotransplantation: a closer look at the banff working classification

Vascularized composite allotransplantation: a closer look at the banff working classification

Current status of vascularized composite tissue allotransplantation

Relative antigenicity of components in vascularized composite allotransplants: An experimental study of microRNAs expression in rat hind limb transplantation model

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