Presented live on Tuesday, October 15th, 2019 • Hosted by the Vascularized Composite Allotransplantation Advisory Council (VCA AC)
"Chronic rejection of human face allografts."
(Am J Transplant. 2019 Apr;19(4):1168-1177. doi: 10.1111/ajt.15143. Epub 2018 Nov 10.)
In this article:
Face vascularized composite allografts (FVCAs) have helped patients with severe facial disfigurement, with acute rejection now largely controlled through iatrogenic immunosuppression. However, little is known regarding the incidence and mechanism(s) of more long-term pathologic alterations in FVCAs that may affect function and graft durability.... [Based on protocol surveillance biopsy specimens for up to an 8-year interval in 7 patients who received FVCAs, the authors] conclude that some patients develop chronic rejection in FVCAs with striking similarities to alterations seen in certain autoimmune cutaneous disorders (lupus erythematosus and scleroderma/chronic sclerodermoid graft-versus-host disease). Identification of relevant pathways and genes, such as JunB and c-Fos, may provide new targets for preventative therapies for chronic immune-mediated changes in vascularized composite allografts.
Christine Lian, MD • Brigham and Women's Hospital, Boston, MA
Leonardo Riella, MD, PhD • Brigham and Women's Hospital, Boston, MA
Linda Cendales, MD • Duke University Medical Center, Durham, NC