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J Reconstr Microsurg 2018; 34(09): 683-684
DOI: 10.1055/s-0038-1651524
Invited Review, WSRM White Papers
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

From Auto- to Allotransplantation: Immunomodulatory Protocol for Hand and Arm Transplantation

W. P. Andrew Lee
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Jaimie T. Shores
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Gerald Brandacher
1   Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

20 January 2018

21 January 2018

Publication Date:
18 May 2018 (online)

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Abstract

Aim To achieve a favorable risk–benefit balance for hand transplantation, an immunomodulatory protocol was developed in the laboratory and translated to clinical application.

Methods Following donor bone marrow infusion into transplant recipients, hand and arm allografts have been maintained on low-dose tacrolimus monotherapy.

Results Good-to-excellent functional recovery has been achieved in patients compliant with medication and therapy, thus restoring autonomous and productive lives.

Conclusion The risk-benefit balance can be tilted in favor of the hand transplant recipients by using an immunomodulatory protocol with minimum immunosuppression.

Keywords

allotransplantation - bone marrow infusion - hand transplantation - vascularized composite allograft - immunomodulation
 

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