Objective To establish and improve the model of heart-thymus composite transplantation.Methods Vascularized both lobes of the thymus is transplanted heterotopically with the heart as a composite graft in rats.This tec...Objective To establish and improve the model of heart-thymus composite transplantation.Methods Vascularized both lobes of the thymus is transplanted heterotopically with the heart as a composite graft in rats.This technique was developed and assessed,and viability of the grafts was evaluated histologically.Results Donor operation costed 38.5±3.52 min,vascular anastomosis costed 25.0±3.28 min,operating successful rate was 90%,acute rejection was observed in SD-Wistar group,viable thymus with normal microarchitecture was maintained in Wistar-Wistar group.Conclusions The improved novel technique for combined heart-thymus transplantation is a valuable method for study of the role of thymus in transplantation immunity.展开更多
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 u...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.展开更多
Face transplant(FT)has evolved enormously in the last 10 years since the successful completion of the first facial transplant.This procedure has become a new reconstructive option for complex facial deformities to res...Face transplant(FT)has evolved enormously in the last 10 years since the successful completion of the first facial transplant.This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces.The authors review the literature and discuss the main surgical,immunological,and ethical aspects as well as the results described in patients undergoing FT.To date there have been more than thirty FT worldwide.The main indication was post-traumatic deformity.In all cases a standard immunosuppression was performed with three drugs,although acute rejection episodes were observed,that could be controlled with conventional immunosuppressive regimen.Overall,functional and aesthetic results have been excellent at short-term and high satisfaction rate exceeded initial expectations,although long-term data are still scarce.Major complications were opportunistic infections.Five deaths that occurred have reopened the ethical debate about the potential complications and concerns of providing informed consent to recipients.Continuous progresses in microsurgical techniques and preoperative planning have promoted the evolution from partial to full FT.All these are on the basis of accurate and careful selection of well-motivated candidates.The next challenge will be getting new immunosuppressive treatment strategies.Although clinical experience has demonstrated the FT viability,it is still considered an experimental procedure in which we have much to learn to define its true role in the current reconstructive surgery and resolve major technical,medical and ethical problems involved.展开更多
文摘Objective To establish and improve the model of heart-thymus composite transplantation.Methods Vascularized both lobes of the thymus is transplanted heterotopically with the heart as a composite graft in rats.This technique was developed and assessed,and viability of the grafts was evaluated histologically.Results Donor operation costed 38.5±3.52 min,vascular anastomosis costed 25.0±3.28 min,operating successful rate was 90%,acute rejection was observed in SD-Wistar group,viable thymus with normal microarchitecture was maintained in Wistar-Wistar group.Conclusions The improved novel technique for combined heart-thymus transplantation is a valuable method for study of the role of thymus in transplantation immunity.
基金grants from the NIH(RO1AG039449)the Carlos Slim Foundation de la Salud(all to SGT)supported by DFG grant KFO 243/1.
文摘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.
文摘Face transplant(FT)has evolved enormously in the last 10 years since the successful completion of the first facial transplant.This procedure has become a new reconstructive option for complex facial deformities to restore the anatomy of patients with severely disfigured faces.The authors review the literature and discuss the main surgical,immunological,and ethical aspects as well as the results described in patients undergoing FT.To date there have been more than thirty FT worldwide.The main indication was post-traumatic deformity.In all cases a standard immunosuppression was performed with three drugs,although acute rejection episodes were observed,that could be controlled with conventional immunosuppressive regimen.Overall,functional and aesthetic results have been excellent at short-term and high satisfaction rate exceeded initial expectations,although long-term data are still scarce.Major complications were opportunistic infections.Five deaths that occurred have reopened the ethical debate about the potential complications and concerns of providing informed consent to recipients.Continuous progresses in microsurgical techniques and preoperative planning have promoted the evolution from partial to full FT.All these are on the basis of accurate and careful selection of well-motivated candidates.The next challenge will be getting new immunosuppressive treatment strategies.Although clinical experience has demonstrated the FT viability,it is still considered an experimental procedure in which we have much to learn to define its true role in the current reconstructive surgery and resolve major technical,medical and ethical problems involved.
