Site Specific Immunosuppression for Promoting Vascularized Composite Allograft Survival and Reducing Systemic Immunosuppression Related Morbidity (original) (raw)

2020

Abstract

Widespread clinical applicability of vascularized composite allotransplantation (VCA) has been limited by the high incidence of rejection and the requirement for systemic, lifelong, multi-drug maintenance immunosuppression for allograft survival that can lead to infectious and metabolic complications. Our goal was to evaluate a site-specific immunosuppressive strategy that promotes VCA graft survival and reduces the need for systemic immunosuppression. Hand and face allografts provide the opportunity for site-specific delivery of immunosuppressive drugs given the accessibility, feasibility of visual monitoring. Conceivably, site-specific graft immunosuppression could provide therapeutic drug levels in the allograft, reduce systemic drug exposure and toxicity, and improve patient compliance and outcomes. This work attempts to develop effective drug delivery strategies for site-specific immunosuppression, while minimizing the need for systemic immunosuppression. We have described two ...

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