Abstract
Composite tissue allograft (CTA) transplantation, such as the clinical face and hand
transplants, has now been performed in multiple centers across the world. The transplants
have successfully treated complex injuries that have either failed conventional approaches
or where autologous reconstruction could not restore both form and function. CTA transplantation
has the potential to improve outcomes over traditional techniques. However, the widespread
application of CTA transplantation continues to be limited by the need for chronic
immunosuppression. Due to the small numbers of CTA transplants performed, any modification
in the immunosuppression used will likely be based from the solid organ literature.
The renal transplantation literature has served as the basis for the current selection
of CTA drug regimens and in this article we review the evidence in the renal transplant
literature for the selection of immunosuppressive regimens. The study then compares
the regimens used in both the face and hand transplantation with those regimens currently
used for renal transplantation.
Keywords
Immunosuppression - composite tissue allotransplantation - face transplantation